吲哚美辛对人牙龈微循环的作用研究  

Effects of indomethacin on gingival microcirculation in human

作　　者：陈铁楼[1] 刘景昌[2] 刘国勤[1] 许兵[3] 蔺世龙[2] 陈骏[1] 吴织芬[4] 周以钧[4] 

机构地区：[1]上海解放军第411医院口腔专科中心牙周病科,上海200081 [2]海军医学研究所全军重点实验室 [3]同济大学化学系 [4]第四军医大学口腔医学院

出　　处：《口腔医学》2009年第1期7-10,共4页Stomatology

基　　金：全军重点实验室基金项目(036);海军后勤部重点课题(2000-3327);国家自然科学基金课题(3870831)

摘　　要：目的探讨吲哚美辛(IND)对牙龈微循环及细胞内分泌因子的作用及机理。方法60例牙周炎患者随机分为IND组和对照组,在治疗前、后和治疗后1个月分别测定牙龈血流量(GBF)、血流速度(BCV)和血浓度(BC),酶免测定龈沟液中血栓素B2(TXB2)和6-酮-前列腺素F1α(6-k-PGF1α),组织学观察牙龈微血管形态变化,免疫组化染色法分析细胞内分泌因子定位及变化。结果IND治疗后牙龈组织中GBF和BCV明显升高,BC明显降低(P<0.01),龈沟液中6-k-PGF1α/TXB2比率明显增加,两组间差异有显著性(P<0.01);IND组治疗后牙龈组织开放血管数量明显增多,血管内皮细胞中线粒体和粗面内质网数量明显增多;治疗后6-k-PGF1α在血管内皮细胞胞浆中染色阳性程度增加,巨噬细胞和浆细胞胞浆中阳性程度降低,TXB2在巨噬细胞和浆细胞胞浆中的染色程度明显降低,血管内皮细胞染色程度增强。治疗后1个月时GBF、BCV和BC与治疗后有显著性差异。结论IND对牙周手术后牙龈微循环的改善有明显作用,此作用是通过对血管内皮细胞和炎细胞内分泌因子6-k-PGF1α和TXB2的分泌、释放的调控来实现的。Objective To study the effects and mechanisms of indomethacin on gingival microcirculation and cell secretion 6-k-PGF1α and TXB2. Melhods 60 cases with periodontitis were divided into 2 groups, group Indomethacin（IND） and group Control（CON）. Analyses were made on the changes of IND on gingival blood flows（GBF）, blood current velocity（BCV）, and blood concentration（BC） were measured by laser doppler flowmeter and the effects of IND on the gingival bloed vessel number and super microstruction of gingiva were measured by light and electron microscope. The 6-k-PGFla, TXB2 contents in gingival cervical fluid（GCF）were measured by enzyme immunoassay and the 6-k- PGF1α,TXB2 in gingiva were located by immunohistochemical analysis. Results There were significant differences of GBF, BCV, BC, and 6- k-PGF1α,TXB2 contents in GCF between group IND and group CON. The GBF, BCV of group IND increased while the BC decreased. Highly significant differences were found in GBF, BCV, BC and 6-k-PGFla and TXB2 contents after indomethacin ＋ falp surgery therapy when compared with the pre-therapy（ P 〈 0.01 ）. The values of GBF, BCV and BC 1 month pest-therapy were improved more markedly in IND group than that of post-therapy. The opened blood vessel number in gingiva of group IND post-therapy increased, and there were more lysosome chondriosomes and endoplasmic veticulums in cytoplasm of endoepithelial cell. The 6-k-PGF1α expression of group IND was strongly positive in vaendothelium cell, and the positive degree in macrophage and plasma cell expression decreased. The TXB2 expression of group IND was positive in vasoendothelium cell, and the positive degrees in macrophage and plasma cells expression decreased significantly. Conclusion Indomethacin combined with flap surgery seems to be even better for treating periodontitis and improving gingival microcirculation. The effects can be achieved by the regulation of vasocndothellum cell and inflammatory cell to secrete and release the 6-k-PGF1α and TXB2.

关 键 词：吲哚美辛 牙龈微循环 细胞因子 牙周炎 机理 微血管 

分 类 号：R783.2[医药卫生—口腔医学]