维持性血液透析患者口腔卫生状况调查及其与微炎症状态的相关因素分析  

The relationship between oral health condition and micro-inflammatory state in maintenance hemodialysis patients

作　　者：刘涛[1] 李根[1] 卢锦莲[1] 胡爱霞[1] 刘情操[1] 

机构地区：[1]黄石市第二医院,黄石435002

出　　处：《中国血液净化》2015年第6期320-324,共5页Chinese Journal of Blood Purification

基　　金：湖北省自然科学基金面上项目(NO.2014CFC1038)

摘　　要：目的调查维持性血液透析(MHD)患者口腔卫生情况,寻找MHD患者口腔疾病与透析微炎症状态和营养状态之间的关系。方法选择MHD患者85名,健康对照组85名。记录一般情况,测取hs CRP、实验室指标及口腔状况检查。对MHD患者组的牙周病指数(PDI)与hs CRP进行相关性分析。将患者分为牙列健康和轻度龋病组(A组)和严重龋病组(B组)、牙周健康和轻度牙周病组(C组)和中、重度牙周病组(D组)。2种分组方法,分别比较MHD组和健康对照组实验室检验指标。结果 MHD患者龋病患病率68.2%。MHD患者组龋齿患病率、已龋损尚未充填的牙(D)、缺失牙(M)、和龋失补指数(DMFT)与健康对照组之间无统计学意义(P>0.05)。MHD患者组充填牙(F)1.3(1.7)明显低于健康对照组(P<0.05)。牙周病患病率83.5%、软垢指数(DI)2.1(1.2)、牙石指数(CI)1.5(0.8)、PDI 3.9(1.9)均明显高于健康对照组(P<0.05)。MHD患者牙周病加重与性别、糖尿病、与透析时间相关(P<0.05)。Logistic回归分析,透析时间和糖尿病是MHD患者牙周病加重危险因素(P<0.01)。透析时间与PDI之间呈正相关(P<0.05)。MHD患者hs CRP水平A组与B组之间无统计学意义(P>0.05)。D组hs CRP(16.0±6.9mmol/L)高于C组(11.1±7.4mmol/L)(P<0.01)。hs CRP与PDI水平呈正相关(P<0.05)。营养状况指标中D组BMI24.2±1.3、ALB 40.8±4.5g/L低于C组BMI 22.1±1.5、ALB 38.7±3.6g/L(P<0.05)。结论 MHD患者口腔卫生状况差,牙周病发生率明显增加,程度较重。随透析龄增加,其牙周病程度进一步加重。慢性严重的牙周炎可能是引起MHD患者微炎症状态的因素之一。Objective To investigate oral changes and oral diseases and the relationship between oral health condition and micro-inflammatory state in maintenance hemodialysis （MHD） patients. Methods We recruited 85 MHD patients and 85 healthy adults as controls for this study. Their general condition, serum hsCRP, other laboratory examinations, and oral status were recorded. The relationship between periodontal dis- ease index （PDI） and hsCRP was analyzed in MHD patients. MHD patients were then divided into healthy dental condition with mild caries group （group A）, and healthy dental condition with severe caries group （group B）, healthy periodontal condition or mild periodontal disease group （group C）, and moderate and se- vere periodontal disease group （group D）. Results of laboratory examinations were compared between MHD patients and healthy controls. Results The prevalence of caries was 68.2% in MHD patients. There were no statistically differences in prevalence of caries, caries not filled yet, missing teeth, and decayed, miss- ing and filled teeth index （DMFT） between MHD patients and healthy controls （P〉0.05）. Filled teeth were lower in MHD patients （1.3） than in healthy controls （1.7） （P〈0.05）. The prevalence of periodontal disease was 83.5% in MHD patients. Debris index was 2.1 and 1.2, calculus index was 1.5 and 0.8, PDI was 3.9 and 1.9 in MHD patients group and healthy control group, respectively, significantly higher in MHD patients group （P〈0.05）. In MHD patients, the aggravation of periodontal disease was related to gender, diabetes melli- tus, and dialysis age （P〈0.05）. Logistic regression demonstrated that dialysis age and diabetes mellitus were the risk factors for the aggravation of periodontal disease （P〈0.01） in MHD patients. Dialysis age was positively correlated with PDI （P〈0.05）. Serum hsCRP was indifferent between group A and group B （P〉0.05）, but was higher in group D （16.0±6.9 mmol/L） than in group C （11.1±7.4 mmo

关 键 词：维持性血液透析 牙周病 龋病 C反应蛋白 微炎症状态 

分 类 号：R318.16[医药卫生—生物医学工程]