牙周保健行为及认知水平对2型糖尿病患者牙周健康和血糖代谢的影响  

Effects of dental health awareness and behaviours on the glycemic metabolic characteristics and periodontal disease of patients with type 2 diabetic

作　　者：李峥[1] 沙月琴[2] 朱凌[3] 张博学[3] 徐菁玲[1] 

机构地区：[1]北京大学第三医院口腔科,北京100191 [2]北京大学口腔医学院.口腔医院牙周科,北京100081 [3]北京大学口腔医学院.口腔医院预防科,北京100081

出　　处：《北京大学学报（医学版）》2013年第6期979-983,共5页Journal of Peking University:Health Sciences

基　　金："十一五"国家科技支撑计划项目(2007BAI18B02);国家自然科学基金(3030479);国家"十五"科技攻关项目(2001BA705B109);卫生部部属医院临床学科重点项目(2010-2012);北京大学"211 工程"基金(94000-246156083);北京大学第三医院院中青年骨干基金 (79494-01) 资助~~

摘　　要：目的：分析2型糖尿病与慢性牙周炎的双向作用关系及影响因素。方法：对83名2型糖尿病患者进行牙周检查、血糖代谢检测及问卷调查。结果：83名2型糖尿病患者中、重度牙周炎患病率为67.5％，与轻度牙周炎个体相比，其牙周炎症程度及附着丧失水平受糖化血红蛋白（glycosylated hemoglobin A1，HbA1C）水平≥8.0％（OR=54.1~143.1）、服用降糖药（OR=12.9~44.6）、生活压力大（OR=16.9~29.6）、对糖尿病治疗状况不满意（OR=16.9~18.0）、牙周保健知识水平低（OR=3.4）、年龄大（OR=1.1）、不能正确进行牙龈炎症判断（OR=13.3）等因素影响，与此同时，患中、重度牙周炎（OR=8.61），刷牙效果差（OR=8.07），不了解菌斑（OR=7.49）的个体HbA1C水平更易控制不良（≥8.0％）。结论：牙周炎严重程度与HbA1C 水平存在双向影响关系，口腔卫生行为及其认知水平在其间发挥协同作用。To analyze the effects of dental health awareness and behaviours on the relationship between glycemic metabolic characteristics and periodontal disease of type 2 diabetic patients. Methods： In the study, 83 subjects with type 2 diabetes mellitus were recruited. The clinical periodontal indexes, such as pocket probing depth （PPD）, attachment loss （AL）, modified bleeding index （mBI）, plaque index （PLI） were obtained with a Williams type periodontal probe; Laboratory examinations including glycosylated haemoglobin A1（HbA1C） were made, glucose assay tested, and the structured questionnaire interview conducted evaluationg the knowledge, attitude and practice （KAP） about periodontal health. Results： The prevalence of moderate and severe periodontitis was 67.5%, compared with mild periodontitis, whose severities were affected by the higher level of HbA1C （≥8.0%） （OR 54.1-143.1）, followed by using glycemic drug （OR=12.9-44.6）, stress （OR=16.9-29.6）, and the dissatisfaction with diabetic therapy （OR=16.9-18.0） et al. Meanwhile the attachment loss conditions were also correlated with the poor periodontal knowledge level（OR=3.4）,older age（OR=1.1）,and misjudgement of gingival inflammation （OR=13.3） et al. On the other hand, individuals with moderate and severe periodontitis, having bad teeth brushing effects and knowing about dental plaque inadequately, had a significantly higher risk for the poorly controlled glycemic results （HbA1C≥8.0%）, and the OR was 8.61, 8.07, and 7.49 respectively. Conclusion： In patients with type 2 diabetes the severity of periodontal disease and the glycemic metabolic level （HbA1C） have a definite bidirectional adverse interrelationship, which is affected by the dental health awareness and behaviours.

关 键 词：糖尿病 2型 牙周炎 口腔保健 健康知识 态度 实践 

分 类 号：R781.42[医药卫生—口腔医学]