慢性牙周炎对冠心病发病和病情稳定性的影响

Effects of chronic periodontitis on heart attack and stability of coronary artery disease

目的 探讨慢性牙周炎对冠心病发病和病情稳定性的影响。方法 对 2 6 6例冠心病患者 (急性心肌梗死 72例 ,不稳定心绞痛 91例 ,稳定性心绞痛 10 3例 )和 2 6 6例正常对照者进行口腔检查 ,比较缺失牙齿数目及牙周指数。结果 冠心病组牙周指数高于对照组 (P <0 0 1) ,调整性别、年龄、体重指数、吸烟史、高血压病及糖尿病史、血脂指标、C反应蛋白、白细胞计数及纤维蛋白原水平后 ,牙周指数仍与冠心病患病率显著相关 ,比数比为 1 76 2 (P <0 0 5 )。急性心肌梗死组及不稳定心绞痛组的牙周指数 ,与对照组和稳定性心绞痛组比较差异均有显著性 (P <0 0 5 ) ,稳定性心绞痛组与对照组相比差异有显著性 (P <0 0 5 )。缺失牙齿数目在各组间差异无显著性。结论 慢性牙周炎影响冠心病发病和病情稳定性 ,是冠心病的独立危险因素。

Objective To investigate the effects of chronic periodontitis on heart attack and stability of coronary artery disease (CAD). Methods Number of missed teeth was recorded and periodontal index evaluated in 266 patients with CAD, including 72 cases of acute mycocardial infarction (AMI sub-group), 91 cases of unstable angina pectoris (UAP sub-group) and 103 cases of stable angina pectoris (SAP sub- group ), and 266 healthy controls. Comparison was made between the both groups and between each sub-group and controls. Results Periodontal index in CAD group was higher than that in control group ( P <0.01). Periodontal index also correlated to CAD with an odds ratio of 1.762 ( P <0.05), adjusted for sex, age, BMI, smoking habits, diabetes, hypertension, levels of serum lipid, C-reactive protein and fibrinogen, and white blood cell count. Periodontal index in AMI sub-group and UAP sub-group was higher than that in control group ( P <0.01) and SAP sub-group ( P <0.05). Periodontal index in SAP sub-group was higher than that in control group, too ( P <0.05). There was no significant difference in number of missed teeth between the three sub-groups and control group ( P >0.05). Conclusions Chronic periodontitis can affect heart attack and stability of CAD, which may be an independent risk factor for CAD.