学龄前龋齿儿童唾液分泌型免疫球蛋白A、乳酸脱氢酶及溶菌酶的表达水平及其临床意义

Expression levels and clinical significance of secretory immunoglobulin A,lactate dehydrogenase and lysozyme in pre-age children with dental caries

目的 探讨学龄前龋齿儿童唾液中唾液分泌型免疫球蛋白(sIgA)、乳酸脱氢酶(LDH)和溶菌酶的表达水平,分析这些生物标志物与龋齿发生的关系。方法 前瞻性选取2019年1月至2022年1月广州中医药大学第一附属医院收治的88例学龄前龋齿儿童作为观察组,并选择同期来我院进行健康检查且未患龋齿的60名儿童作为对照组。通过唾液收集法获取非刺激性唾液样本,利用放射免疫法、酶联免疫吸附试验法和比色法分别测定sIgA、LDH和溶菌酶的水平。观察组患儿接受伢典凝胶微创去龋治疗技术治疗1个月。比较治疗前观察组与对照组儿童唾液中sIgA、LDH及溶菌酶水平,观察组不同龋齿数患儿治疗前唾液中sIgA、LDH及溶菌酶水平,以及观察组患儿治疗前和治疗后1个月唾液中sIgA、LDH及溶菌酶水平。结果 观察组患儿唾液中sIgA和溶菌酶水平分别为(70.29±12.28)、(29.93±7.89)μg/mL,均明显低于对照组[(97.31±11.12)、(36.41±8.21)μg/mL],LDH水平为(2 323.29±266.29) U/L,明显高于对照组[(1 231.92±241.33) U/L],差异均有统计学意义(P<0.05)。观察组龋齿数≥6颗患儿的唾液中sIgA水平为(62.12±8.21)μg/mL,明显低于龋齿数<6颗患儿[(72.97±9.33)μg/mL],LDH为(2 465.58±281.29) U/L,显著高于龋齿数<6颗患儿[(2 259.29±278.33) U/L],差异均有统计学意义(P<0.05),但两组儿童唾液中溶菌酶水平比较差异无统计学意义(P>0.05)。治疗后1个月,观察组患儿唾液中sIgA和溶菌酶水平分别为(83.65±11.26)、(34.61±9.12)μg/mL,均较治疗前[(72.33±9.31)、(29.98±8.93)μg/mL]明显增高,LDH水平为(1 433.58±269.32) U/L,较治疗前[(2 361.11±255.99) U/L]明显降低,差异均有统计学意义(P<0.05)。结论 学龄前龋齿儿童唾液中sIgA、溶菌酶水平明显低于健康儿童,LDH水平明显高于健康儿童,且龋齿数越多,sIgA、LDH水平变化越显著。经伢典凝胶微创去龋治疗后,唾液中sIgA、LDH及溶菌酶水平趋于正常。唾液中sIgA、LDH及溶菌酶的表达水平与龋齿发生和发展密切联系,为龋齿的预防和治疗提供了重要的生物学依据。

Objective To investigate the expression levels of secretory immunoglobulin A(sIgA),lactate dehydrogenase(LDH)and lysozyme in saliva of preschool children with dental caries,and to analyze the relationship between these biomarkers and the occurrence of dental caries.Methods A total of 88 preschool children with dental caries admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2019 to January 2022 were selected as the observation group and 60 children without dental caries who underwent health examination during the same period in our hospital were selected as the control group.The contents of sIgA,LDH and lysozyme were determined by radioimmunoassay,enzyme-linked immunosorbent assay and colorimetry.The children in the observation group were treated with carisolv gel minimally invasive caries removal for 1 month.The levels of sIgA,LDH and lysozyme in saliva of children in the observation group and the control group before treatment were compared.The levels of sIgA,LDH and lysozyme in saliva of children with different caries in the observation group before treatment,and the levels of sIgA,LDH and lysozyme in saliva of children in the observation group before treatment and 1 month after treatment were compared.Results The levels of sIgA and lysozyme in saliva of the observation group were(70.29±12.28)and(29.93±7.89)μg/mL,respectively,which were significantly lower than those of the control group[(97.31±11.12)and(36.41±8.21)μg/mL],the level of LDH was(2323.29±266.29)U/L,which was significantly higher than that of the control group[(1231.92±241.33)U/L],and the differences were statistically significant(P<0.05).The level of sIgA in saliva of children with caries≥6 teeth in the observation group was(62.12±8.21)μg/mL,which was significantly lower than that of children with caries<6 teeth[(72.97±9.33)μg/mL],and the level of LDH was(2465.58±281.29)U/L,which was significantly higher than that of children with caries<6 teeth[(2259.29±278.33)U/L],the differences were statistically significant(P<0.05),but there was no statistically significant difference in the level of lysozyme in saliva between the two groups(P>0.05).One month after treatment,the levels of sIgA and lysozyme in the saliva of the observation group were(83.65±11.26)and(34.61±9.12)μg/mL,respectively,which were significantly higher than those before treatment[(72.33±9.31)and(29.98±8.93)μg/mL],the level of LDH was(1433.58±269.32)U/L,which was significantly lower than that before treatment[(2361.11±255.99)U/L],and the differences were statistically significant(P<0.05).Conclusion The levels of sIgA and lysozyme in saliva of preschool children with dental caries were significantly lower than those of healthy children,and the level of LDH was significantly higher than that of healthy children.The more the number of dental caries,the more significant the changes of sIgA and LDH levels.After treatment,the levels of sIgA,LDH and lysozyme in saliva tended to be normal.The expression levels of sIgA,LDH and lysozyme in saliva are closely related to the occurrence and development of dental caries,which provides an important biological basis for the prevention and treatment of dental caries.