冠心病患者牙周炎严重程度对血清超敏C反应蛋白和TNF-α及冠脉狭窄程度的影响  

Effect of Periodontitis on Serum Hs-CRP and TNF-α Levels and Severity of Coronary Artery Stenosis in Coronary Heart Disease

作　　者：冯磊[1] 杨军英[1] 任静[1] 伍贵富[2] 陈珊[1] 周倩冰[1] 胡承恒[2] 杜志民[2] 凌莉[3] 

机构地区：[1]中山大学附属第一医院口腔科,广东广州510080 [2]中山大学附属第一医院心血管医学部,广东广州510080 [3]中山大学统计与流行病学系,广东广州510080

出　　处：《中山大学学报（医学科学版）》2012年第6期797-802,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2007B031500018;2009B060700042)

摘　　要：【目的】研究不同严重程度的牙周炎对冠心病患者血清超敏C反应蛋白(hs-CRP)和肿瘤坏死因子α(TNF-α)及冠脉狭窄程度的影响,探讨牙周炎与冠心病之间潜在的相关性。【方法】冠脉造影确诊为冠心病的142例患者,根据临床附着丧失的程度分为三组:冠心病牙周健康组32例(C组),冠心病伴轻度牙周炎组32例(C+P1组),冠心病伴中重度牙周炎组78例(C+P2组)。依据冠状动脉造影结果,对其冠脉狭窄程度进行评分。选择经冠脉造影排除冠心病的单纯中重度牙周炎患者31例为对照组(P组)。检测血清hs-CRP和TNF-α的含量。用SPSS13.0软件进行统计学分析。【结果】冠心病伴中重度牙周炎组血清hs-CRP含量高于单纯中重度牙周炎组,差异有统计学意义;随着牙周炎严重程度的增加,冠心病患者的血清hs-CRP、TNF-α和冠脉狭窄程度有显著升高,冠心病伴中重度牙周炎组的血清hs-CRP、TNF-α含量和冠脉狭窄程度高于冠心病伴轻度牙周炎组,差异有统计学意义。【结论】中重度牙周炎的冠心病患者血清炎症水平较高,冠脉狭窄程度较严重,提示牙周感染可能通过以上炎症介质及级联反应,引发或加重冠心病。[ Objective ] To investigate the effect of periodontitis on serum hs-CRP （high sensitive C-reactive protein） and TNF-α （tumor necrosis factor-alpha） levels and the severity of coronaIy artery stenosis in coronary heart disease （CHD）, to help identify the potential correlation of periodontitis and CHD. [ Methods] A total of 142 patients with CHD who underwent their angiography were enrolled into the study. According to periodontal examination, the patients were divided into three groups： 32 in-patients were healthy periodontitis （group C）, 32 in-patients were initial periodontitis （group C＋P1 ）, 78 in-patients were moderate and severe periodontitis （group C＋P2）. Each give a score according the severity of periodontitis and coronary artery stenosis. Meanwhile, 31 out-patients with simple moderate and severe periodontitis were selected in the Department of Stomatology （group P）. The correlation between the severity of periodontitis and serum hs-CRP and TNF-α levels in the patients with coronary heart disease was analyzed by using SPSS13.0. [Results] There was statistical significance of serum hs-CRP between C＋P2 group and P group. There were significant elevation of serum hs-CRP and TNF-ot and the severity of coronary artery stenosis accompanied with initial to moderate and severe periodontitis in CHD patients, C ＋ P2 group was significantly greater than C ＋ P1 group. [Conclusions] The study concludes that moderate and severe periodontitis may aggravate inflammation and the severity of coronary artery stenosis in CHD patients. Through the above inflammation and cascade reaction, periodontal infection may cause or worsen coronary heart disease.

关 键 词：牙周炎 冠心病 肿瘤坏死因子Α 超敏C反应蛋白 冠脉狭窄 

分 类 号：R392[医药卫生—免疫学]