糖尿病前期患者的牙周状况研究  

Study on periodontal status of patients with pre-diabetes

作　　者：靳东思奇 廖雁婷[1] 和璐[1] 孟焕新[1] 李蓬[1] Jin Dongsiqi;Liao Yanting;He Lu;Meng Huanxin;Li Peng(Peking University School and Hospital of Stomatology & Ndtioruil Clinical Research Center for Oral Diseases & National Engineering laboratory for Digital and Material Technology of Stomatology & Beijing Key hiboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院牙周科国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,100081

出　　处：《中华口腔医学杂志》2019年第3期157-163,共7页Chinese Journal of Stomatology

摘　　要：目的研究糖尿病前期患者的牙周状况及特点,指导发现牙周炎高危人群以利于对慢病干预计划的制定。方法从高血压联盟研究所观察的北京市石景山区一队列人群中,选取血糖正常者88人(血糖正常组)、糖尿病前期患者27例(糖尿病前期组)、血糖控制良好的糖尿病患者58例(血糖控制好组)和血糖控制差的糖尿病患者72例(血糖控制差组)进行牙周临床检查,检查内容包括菌斑指数、探诊深度、出血指数、探诊出血(bleeding on probing,BOP)、临床附着丧失及缺牙数,并应用PCR技术检测其唾液中牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)、福赛坦纳菌(Tannerella forsythia,Tf)、齿垢密螺旋体(Treponema denticola,Td)、直肠弯曲菌(Campylobacter rectus,Cr)和变黑普氏菌(Prevotella nigrescens,Pn),比较不同血糖状况的4组受检者牙周状况及唾液中牙周致病菌的检出差异。结果4组受检者探诊深度差异均无统计学意义(P>0.05)。糖尿病前期组的附着丧失[(2.29±1.35)mm]显著低于血糖控制差组[(3.07±1.45)mm](P=0.04),缺牙数[2.0(7.0)]显著低于血糖控制好组[5.0(9.0),P=0.02]及血糖控制差组[5.0(10.0),P=0.04];糖尿病前期组BOP阳性位点百分比[BOP(+)%][(63.89±20.03)%]显著高于血糖正常组[(54.51±22.29)%,P=0.04]及血糖控制好组[(53.12±21.77)%](P=0.03)。糖尿病前期组Pg、Tf的检出率(分别为81.5%、96.3%)均显著高于血糖控制差组(分别为54.2%、76.4%)(P=0.02,P=0.01);糖尿病前期组Pg[1.58(4.75)]及Tf相对含量[5.46(7.77)]均显著高于血糖控制差组[Pg:0.60(1.87),P=0.01;Tf:1.63(3.06),P<0.01],其Pn相对含量[0.85(1.68)]显著高于血糖正常组[0(1.02),P=0.04]。结论未经干预的糖尿病前期患者牙周致病微生物感染及BOP(+)%重于其他三组,是牙周炎高风险人群。Objective To investigate periodontal status of patients with pre-diabetes and evaluate the prevalence of periodontal pathogens in oral cavity. Methods All the subjects were under regular care in urban area of Beijing, including 88 subjects with normal blood glucose (normal blood glucose group), 27 pre-diabetic patients (pre-diabetic group), 58 well-controlled diabetic patients (glucose well controlled group) and 72 poor-controlled diabetic patients (glucose poor controlled group). Whole unstimulated saliva samples were collected before periodontal examination. Periodontal parameters, including plaque index (PLI), probing depth (PD), bleeding index (BI), bleeding on probing (BOP) and clinical attachment loss (CAL), were examined at mesial-buccal and distal-lingual sites of each tooth. Number of missing teeth was recorded. DNA was extracted from the salivary deposition, Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Campylobacter rectus (Cr), and Prevotella nigrescens (Pn) were detected by using PCR method based on 16SrRNA. Periodontal status and prevalence and quantity of the pathogens under various blood glucose states were compared. Results The PD scores of four groups had no statistical differences. The CAL [(2.29±1.35) mm] and the number of missing teeth[2.0 (7.0)] in pre-diabetic group were significantly lower than that in glucose poor controlled group [(3.07±1.45) mm, P=0.04 and 5.0 (10.0), P=0.04, respectively]. The number of missing teeth in pre-diabetic group [2.0 (7.0)] was significantly lower than that in glucose well controlled group [5.0 (9.0), P=0.02]. The percent of bleeding on probing [BOP(+)%] in pre-diabetic group [(63.89±20.03)%] was significantly higher than that in normal blood glucose group [(54.51±22.29)%, P=0.04] and glucose well controlled group [(53.12±21.77)%, P=0.03]. The prevalence of Pg in pre-diabetic group (81.5%) was significantly higher than that in glucose poor controlled group (54.2%, P=0.02). The prevalence of Tf in pre-diabetic group (

关 键 词：糖尿病前期 牙周炎 疾病管理 牙周致病菌 

分 类 号：R587.1[医药卫生—内分泌]