环氧化酶抑制剂辅助机械治疗方案对重度慢性牙周炎患者炎性细胞因子及骨保护素水平的影响  

Effects of cyclooxygenase inhibitor assisted mechanical therapy on inflammatory cytokines and Osteoprotegerin levels in patients with severe chronic periodontitis

作　　者：施元洁 魏本娟[1] SHI Yuan-jie;WEI Ben-juan(Department of Stomatology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China.)

机构地区：[1]上海交通大学医学院附属仁济医院口腔科,上海200127

出　　处：《临床和实验医学杂志》2019年第9期975-978,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市卫生和计划生育委员会课题(编号:201640173)

摘　　要：目的研究环氧化酶抑制剂辅助机械治疗方案对重度慢性牙周炎患者牙周指标、炎症因子和骨保护素(OPG)水平的影响。方法选择2017年1～12月在上海交通大学医学院附属仁济医院接受治疗的重度慢性牙周炎患者92例进行前瞻性研究。用随机数表法分为对照组和观察组,每组各46例。对照组患者给予牙周机械治疗,包括根面平整、龈上洁治和龈下刮治等,并在牙周袋内注入盐酸米诺环素软膏;观察组患者在牙周机械治疗的基础上采用盐酸米诺环素软膏结合布洛芬缓释凝胶注射治疗。比较两组患者的临床疗效、牙周指标、炎症因子和OPG水平等。结果观察组患者痊愈10例(21. 74%),显效21例(45. 65%),有效12例(26. 09%),总有效率为93. 48%,对照组分别为5例(10. 87%)、15例(32. 61%)、16例(34. 78%)、10例(21. 74%),总有效率仅为78. 26%(P <0. 05)。观察组患者的龈沟出血指数(BI)、菌斑指数(PLI)、附着水平(AL)和牙周袋深度(PD)等牙周指标均低于对照组(P <0. 05)。观察组患者的超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)等炎症因子水平均低于对照组(P <0. 05)。观察组患者的OPG水平高于对照组,核因子κB受体活化因子配体(RANKL)和RANKL/OPG水平低于对照组(P <0. 05)。结论重度慢性牙周炎患者采用布洛芬联合盐酸米诺环素辅助机械治疗疗效显著,有助于牙周组织的恢复及重建,降低炎症因子水平,改善牙周指标,值得在临床推广应用。Objective To investigate the effects of cyclooxygenase inhibitor assisted mechanical therapy on periodontal index,inflammatory factors and Osteoprotegerin(OPG)levels in patients with severe chronic periodontitis.Methods Prospective study,92 patients with severe chronic periodontitis who treated in Renji Hospital,Shanghai Jiaotong University School of Medicine were selected from January to December 2017.The patients were divided into the control group(n=46)and the observation group(n=46)using random number table method.The control group was treated with periodontal mechanical treatment,including root surface leveling,gingival cleaning and subgingival scaling,and the injection of Minocycline hydrochloride ointment in the periodontal pocket.The patients in the observation group were treated with Minocycline hydrochloride ointment combined with ibuprofen on the basis of periodontal mechanical treatment.Compared the clinical efficacy,periodontal index,inflammatory factors and OPG levels between the two groups.Results In the observation group,10 cases(21.74%)were cured,21 cases(45.65%)were markedly effective,12 cases(26.09%)were effective,the total effective rate was 93.48%,in the control group,there were respectively 5 cases(10.87%),15 cases(32.61%),16 cases(34.78%)and 10 cases(21.74%),the total effective rate was only 78.26%(P<0.05).The periodontal indices of sulcular bleeding index(SBI),plaque index(PLI),attachment level(AL)and depth of pocket(PD)in the observation group were lower than those in the control group(P<0.05).The levels of inflammatory factors such as high sensitive C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6)and Interleukin-8(IL-8)in the observation group were lower than those in the control group(P<0.05).The OPG level of the observation group was higher than that of the control group,while the levels of receptor activator of nuclear factor kappa B ligand(RANKL)and RANKL/OPG were lower than those of the control group(P<0.05).Conclusion In patients with severe chronic p

关 键 词：慢性牙周炎 环氧化酶抑制剂 机械治疗 炎性因子 骨保护素 

分 类 号：R781.42[医药卫生—口腔医学]