低能量激光配合牙周基础治疗对糖尿病合并慢性牙周炎患者龈沟液细胞因子及LPS、leptin的影响  

Effects of low level laser combined with basic periodontal therapy on cytokines and LPS, leptin in gingival crevicular fluid of diabetes mellitus complicated with chronic periodontitis patients

作　　者：李凤 徐华顺[1] LI Feng;XU Hua-shun(Department of Stomatology, Shanghai No.8 People's Hospital. Shanghai 200235, China)

机构地区：[1]上海市第八人民医院口腔科,上海200235

出　　处：《上海口腔医学》2018年第6期637-640,共4页Shanghai Journal of Stomatology

基　　金：上海市卫计委青年项目(20164Y0123)

摘　　要：目的:分析低能量激光照射疗法(low level laser treatment, LLLT)配合牙周基础治疗对糖尿病合并慢性牙周炎(diabetes mellitus complicated with chronic periodontitis, DMCP)患者龈沟内细胞因子及LPS、Leptin的影响。方法:将2016年1月—2017年1月间收治的80例DMCP患者依照随机信封法分为实验组及对照组,每组40例。对照组采用牙周基础治疗,实验组采用低剂量激光配合牙周基础治疗。治疗前及治疗后3个月检测患者口腔PD、SBI及CAL水平;采集患者空腹静脉血,检测血液中糖代谢指标;采集患者龈沟液,检测龈沟液中炎症因子水平。采用SPSS19.0软件包对数据进行统计学分析。结果:经治疗后2组CAL、PD及SBI水平均显著降低(P<0.05),治疗后实验组CAL、PD及SBI水平显著低于对照组(P<0.05)。治疗后2组患者血中FBG及HbA1c水平均显著降低(P<0.05),治疗后实验组FBG及HbA1c水平显著低于对照组(P<0.05)。治疗后2组患者龈沟液中hs-CRP、IL-1β及TNF-α水平均显著降低(P<0.05),治疗后实验组患者龈沟液中hs-CRP、IL-1β及TNF-α水平显著低于对照组(P<0.05)。治疗后2组患者龈沟液LPS显著降低,Leptin水平显著升高(P<0.05),实验组龈沟液中LPS显著低于对照组,Leptin水平显著高于对照组(P<0.05)。结论:低能量激光配合牙周基础治疗,可有效降低DMCP患者血糖水平及龈沟内LPS水平,提高Leptin水平,显著改善病灶区炎症反应,提高临床疗效。PURPOSES:To analyze the effect of low level laser treatment combined with basic therapy periodontal on cytokines and lipopolysaccharide,leptin in gingival sulcus of patients with diabetes mellitus complicated with chronic periodontitis (DMCP).METHODS:From January 2016 to January 2017,80 patients with DMCP were randomly divided into experimental group and control group.Patients in the control group received basic periodontal therapy,while patients in the experimental group received low dose laser combined with basic periodontal treatment.Before treatment and 3 months after treatment,oral PD,SBI and CAL levels were detected in all patients.Venous blood was collected,HbA1c and FPG levels in blood serum were detected.TNF-α,IL-1,hs-CRP,LPS,leptin in gingival crevicular fluid were detected.Statistical analyses were performed using SPSS19.0 software package.RESULTS:After treatment,CAL,PD,SBI,FBG,HbA1c,TNF-α,IL-1,hs-CRP,LPS levels were significantly decreased,Leptin level increased in both group,and the difference was significant (P<0.05).After treatment,CAL,PD,SBI,FBG,HbA1c,TNF-α,hs-CRP,IL-1 and the level of LPS in the experimental group was significantly lower than the control group (P<0.05),and the level of leptin was significantly higher than that of the control group (P<0.05).CONCLUSIONS:Low level laser combined with basic periodontal treatment can effectively reduce LPS level of DMCP patients in gingival sulcus,and improve the level of Leptin,significantly improve the inflammatory reaction and clinical efficacy.

关 键 词：低能量激光 牙周基础治疗 糖尿病合并慢性牙周炎 脂多糖 瘦素 

分 类 号：R780.1[医药卫生—口腔医学]