光动力疗法治疗糖尿病合并慢性牙周炎的疗效和影响因素

Effect and Influencing Factors of Photodynamic Therapy on Diabetes Mellitus Complicated with Chronic Periodontitis

目的探讨光动力疗法(photodynamic therapy,PDT)治疗糖尿病合并慢性牙周炎的疗效及影响因素。方法选取2020年6月至2022年7月,行PDT联合牙周基础治疗的糖尿病合并慢性牙周炎患者98例设为观察组,在牙周袋中注入剂量为0.2 ml 0.01%亚甲蓝溶液后10 s,应用激光照射,照射功率密度100 mW/cm 2,光斑直径约4 mm,时间1 min,每周1次,连续治疗4周。同期选取98例实施牙周基础治疗的糖尿病合并慢性牙周炎患者设立为对照组,比较两组患者治疗后1个月的总有效率、超敏C反应蛋白(hypersensitive c-reactive protein,hs-CRP)、白介素1β(interleukin 1β,IL-1β)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、牙周探针深度(periodontal probe depth,PD)、附着丧失(attachment loss,AL)、探诊出血指数(bleeding index was probed,BOP);并根据治疗效果将观察组分为有效组和无效组,对比两组的基线资料,采用二分类Logistic回归分析影响观察组患者治疗效果的危险因素。结果观察组总有效率高于对照组(P<0.05),并根据治疗效果将观察组分为有效组(n=83)和无效组(n=15)。治疗后1个月,观察组的hs-CRP、IL-1β、TNF-α、PD、AL、BOP低于对照组(P<0.05)。而对年龄、吸烟、糖尿病病程、HbA1c、FPG、2hPG、刷牙时间、刷牙次数等资料比较,差异具有统计学意义(P<0.05)。logistic回归模分析显示,年龄≥60岁、吸烟、糖尿病病程>5年、HbA1c≥7.5%、空腹血糖>7.0 mmol/L、2 h血糖>10.0 mmol/L、刷牙时间≤3 min、刷牙次数≤2次是影响糖尿病合并慢性牙周炎患者治疗效果的独立危险因素(P<0.05)。结论光动力疗法联合牙周基础治疗糖尿病合并慢性牙周炎有利于减轻牙周炎症反应。

Objective To explore the efficacy and influencing factors of photodynamic therapy in the treatment of diabetes mellitus complicated with chronic periodontitis.Methods Totally 98 patients with diabetes mellitus complicated with chronic periodontitis who received PDT plus periodontal basic therapy in our hospital over the period from Jun.2020 to Jul.2022 were selected as the research object to form the observation group,while 98 patients with diabetes mellitus complicated with chronic periodontitis who received periodontal basic therapy over the same period were selected to form the control group.One month after the treatment,the total effective rate,hypersensitivity C-reactive protein(hs-CRP),interleukin 1β(IL-1β),tumor necrosis factorα(TNF-α),the periodontal probe depth(PD),loss of attachment(AL)and bleeding index was probed(BOP)of the two groups were compared.The patients in the observation group were further divided into an effective group(n=83)and ineffective group(n=15).Based on the comparison of the baseline data of the two groups,the risk factors affecting the treatment effect of the patients in the observation group were analyzed with binary logistic regression.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).One month after the treatment,the levels of hs-CRP,IL-1β,TNF-α,PD,AL and BOP in the observation group were lower than those in the control group(P<0.05).As to the comparison of age,smoking,diabetes course,HbA1c,FPG,2hPG,brushing time and brushing times,the difference was statistically significant(P<0.05).It was revealed via logistic regression model analysis that age≥60 years,smoking,diabetes duration>5 years,HbA1c≥7.5%,FPG>7.0 mmol/L,2hpg>10.0 mmol/L,brushing time≥3 minutes and brushing times≥2 times were the independent risk factors affecting the therapeutic effect of diabetic patients with chronic periodontitis(P<0.05).Conclusions Photodynamic therapy for diabetes mellitus complicated with chronic periodontitis is beneficial to alleviate the reaction of periodontitis.The therapeutic effect is influenced by many factors.