牙周非手术治疗对2型糖尿病伴牙周炎患者牙周致病菌及糖化血红蛋白的影响  

Effects of Periodontal Non-surgical Therapy on Periodontal Pathogens and Glycated Hemoglobin in Patients with Type 2 Diabetes Mellitus Complicated with Periodontitis

作　　者：寇育荣[1,2] 李倩[1] 王宏岩[2] 潘春玲[2] 潘亚萍[1,2] 

机构地区：[1]中国医科大学口腔医学院口腔生物学教研室,沈阳110002 [2]中国医科大学口腔医学院牙周科,沈阳110002

出　　处：《中国医科大学学报》2013年第11期1012-1015,共4页Journal of China Medical University

基　　金：辽宁省自然科学基金(201202294)

摘　　要：目的从微生物学角度探讨牙周非手术治疗对糖尿病(DM)的影响及其可能机制。方法 25名2型DM伴牙周炎患者接受牙周非手术治疗,在基线及治疗后2周、4周、3个月和6个月检测探诊出血、牙周袋深度等牙周临床指数和糖化血红蛋白(HbA1c)等血糖代谢指标,同时采用PCR检测龈下菌斑中牙龈卟啉单胞菌(P.gingivalis)等牙周致病菌。结果 25例患者经牙周非手术治疗牙周临床指数均较基线时有明显改善(P<0.05),P.gingivalis等牙周致病菌的检出率均显著下降(P<0.05),尤其fimAⅠb型和Ⅱ型P.gingivalis的检出率在治疗后显著降低(P<0.05)。HbA1c治疗后无显著改善(P>0.05),但血糖升高者的P.gingivalis检出率显著高于血糖降低者的P.gingivalis检出率(P<0.05),并且fimAⅡ型P.gingivalis仅能在血糖升高者的龈下菌斑中检出。结论牙周非手术治疗可减少2型DM患者龈下菌群中牙周致病菌的数量,改善牙周状态,2型DM患者血糖控制不良可能与P.gingivalis,尤其是fimAⅡ型P.gingivalis的存在有关。ObjectiveTo investigate the effects of periodontal non surgical therapy on diabetes mellitus,and explore its possible mechanism from the perspective of microbiology.MethodsTwenty five type 2 diabetes mellitus(DM)patients complicated with chronic periodontitis were recruit edandtreatedwithperiodontalnon surgicaltherapy.Clinicalperiodontalindexincludingpocketdepth(PD),bleedingonprobing(BOP)andmet abolic parameters of glycated hemoglobin(HbA1c)were determined at baseline and various time points for 6 months following treatment. Periodon talpathogenssuchasPorphyromonasgingivalis(P. gingivalis)insubgingivalplaqueweredetectedbyapolymerasechainreactionmethod.Results In 25 patients,clinical periodontal index afternon surgical therapy were significantly improved compared with the baseline(P <0.05). The bacteri al detection rate of periodontal pathogens including P. gingivalis,especially that of P. gingivalis with type Ⅱ fimA gene,decreased markedly(P < 0.05). The difference of HbA1c after therapy is not statistically significant(P > 0.05). However,P. gingivalis was detected more frequently in sub jects with increased HbA1c values after periodontal treatment than in those patients with decreased HbA1c values(P < 0.05). P. gingivalis with type Ⅱ fimA genotype was detected only in HbA1c increased subjects.ConclusionPeriodontal non surgical therapy could reduce the amount of periodontalpathogensinsubgingivalplaquefrompatientswithDMcomplicatedwithchronicperiodontitisandimprovetheperiodontalcondition.The poorlycontrolledglycemiclevelmayberelatedtothepresenceofP. gingivalis,especiallyP. gingivalis withtype Ⅱ fimAgenotype.

关 键 词：牙周炎 2型糖尿病 牙龈卟啉单胞菌 

分 类 号：R781.4[医药卫生—口腔医学]