口腔血链球菌和冠心病相关性探讨  

The relativity between Streptococcus sanguis group and coronary heart disease

作　　者：邓淑丽[1] 陈晖[1] 张卫东[1] 

机构地区：[1]浙江大学医学院附属口腔医院口腔内科,杭州310006

出　　处：《中华口腔医学杂志》2002年第3期222-224,共3页Chinese Journal of Stomatology

基　　金：浙江省科委研究基金资助项目 (97110 3 12 9)

摘　　要：目的　探讨口腔血链球菌和冠心病的相关关系。方法　调查了 5 9例患者 (其中冠心病组 4 1例 ,对照组 18例 ,均通过冠状动脉造影确诊 )的社会地位、吸烟、饮酒、血脂和口腔健康状况。标本用血链球菌选择性培养基 (NAYS B)培养并记录患者唾液和龈下菌斑中的血链球菌数。通过常规生化法和AP PCR对血链球菌各菌种进行了分类鉴定。结果　在逐步多元回归分析中 ,均衡了冠心病经典危险因素影响后 ,唾液和龈下菌斑中血链球菌量与冠脉狭窄程度相关 ,唾液中血链球菌均数对照组为 (35 8± 5 4 0 )× 10 8CFU/L ,冠心病组为 (435± 4 2 2 )× 10 8CFU/L ,F =2 72 ,P =0 0 8;前牙龈下菌斑的血链球菌均数对照组为 (98± 16 4 )× 10 7CFU/L ,冠心病组为 (331± 4 84 )× 10 7CFU/L ,F =5 5 4 ,P =0 0 2 ;后牙龈下菌斑的血链球菌均数对照组为 (185± 2 32 )× 10 7CFU/L ,冠心病组为 (35 2± 381)×10 7CFU/L ,F =2 86 ,P =0 10。冠心病组血链球菌和高氏链球菌检出率在唾液 (χ2 =10 937,P <0 0 1)和龈下菌斑中 (χ2 =8 5 82 ,P <0 0 5 )明显高于对照组 ,而缓症链球菌和口腔链球菌检出率在两组中差异无显著性。结论　冠心病患者口腔唾液和龈下菌斑中的血链球菌量明显增多可能与冠心病的发生。Objective To study the relativity between Streptococcus sanguis group(SSG) and coronary heart disease(CHD). Methods 41 individuals were diagnosed with CHD and 18 normals served as controls. All of them had undergone coronary angiography. Their social class (including education and wages), smoking, drinking, blood lipids and oral health were also recorded. SSG in saliva and subgingival plaque were cultivated in NAYS B agar plates and counted. SSG were identified into species with routine biochemical reaction and AP PCR. Results In the multiple step regression analysis, the amount of SSG in saliva and subgingval plaque were positively associated with severe coronary atheromatosis after adjusting the classical risk factors of CHD. The average amount of SSG in saliva was (435±422)×10 8CFU/L in CHD group and (358±540) ×10 8CFU/L in control group, F =2 72, P =0 08;the average amount of SSG in incisor was (331±484)×10 7CFU/L in CHD group and (98±164) ×10 7CFU/L in control group, F =5 54, P =0 02; the average amount of SSG in molar was (352±381) ×10 7CFU/L in CHD group and (185±232) ×10 7CFU/L in control group, F =2 86, P =0 10. S.sanguis and S.gordonii were more in CHD group than in control group ( P < 0 05),whereas S.mitis and S.oralis were the same in two groups( P > 0 05). Conclusion The increase of SSG in oral floras may play an important role in the occurrence of CHD.

关 键 词：口腔血链球菌 冠心病 冠状动脉狭窄 AP-PCR 血小板聚集反应 

分 类 号：R541.4[医药卫生—心血管疾病]