牙周基础治疗对龈沟液和血清内皮素、VEGF-A和TNF-α水平的影响  

Effects of basic periodontal treatment on endothelin, vascular endothelial growth factor-A and tumor necrosis factor-α levels in gingival crevicular fluid and serum

作　　者：林哲靖 罗仁惠 谢莉莉[3] 吴晓栩 LIN Zhe-jing;LUO Ren-hui;XIE Li-li;WU Xiao-yu(Department of Stomatology, Shenzhen Hospital of Guangzhou University of Chinese Medicine,Shenzhen 518034, Guangdong Province;Department of Stomatology, Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou 510800, Guangdong Province;Department of Stomatology, Hainan General Hospital. Haikou 570100, Hainan Province;Department of Stomatology, Liwan District People's Hospital of Guangzhou. Guangzhou 510000, Guangdong Province, China)

机构地区：[1]广州中医药大学深圳医院口腔科,广东深圳518034 [2]广州市中西医结合医院口腔科,广东广州510800 [3]海南省人民医院口腔科,海南海口570100 [4]广州市荔湾区人民医院口腔科,广东广州510000

出　　处：《上海口腔医学》2019年第5期504-508,共5页Shanghai Journal of Stomatology

基　　金：海南省自然科学基金(20158321)

摘　　要：目的:观察非手术性牙周治疗对龈沟液和血清中内皮素(endothelin,ET)、血管内皮细胞生长因子A(vascular endothelial growth factor-A,VEGF-A)和肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平的影响.方法:收集2017年10月-2018年6月于广州中医药大学深圳医院就诊的牙周炎患者57例及同期来院进行体检的43名健康人,分别作为牙周炎组与正常对照组.牙周炎组患者给予龈下深刮和根面平整治疗6周.检测2组受试者治疗前、后牙龈探诊出血(bleeding on probing,BOP)率、菌斑指数(plaque index,PI)、探诊深度(probe depth,PD)、临床附着水平(clinical attachment level,CAL)及牙龈指数(gingival index,GI)等牙周临床参数,以及龈沟液与血清中内皮素、VEGF-A和TNF-α水平,分析牙周炎患者治疗前龈沟液中ET水平与VEGF-A及TNF-α水平的关系.采用SPSS 21.0软件包对数据进行统计学分析.结果:正常对照组受试者BOP、PI、PD、CAL及GI等牙周临床参数均显著小于牙周炎组患者(P<0.05);牙周炎组患者治疗前BOP、PI、PD、CAL及GI等牙周临床参数均显著大于治疗后(P<0.05);治疗后,牙周炎组患者龈沟液与血清中ET、VEGF-A及TNF-α水平较治疗前显著下降(P<0.05);且牙周炎组患者治疗前、后龈沟液与血清中ET、VEGF-A及TNF-α水平均显著大于正常对照组(P<0.05);牙周炎患者治疗前龈沟液中ET水平与VEGF-A水平无显著相关性(P>0.05),但治疗前龈沟液中ET水平与TNF-α水平呈显著正相关(P<0.05).结论:非手术性治疗可降低牙周炎患者龈沟液与血清中ET、VEGF-A、TNF-αt水平,改善患者牙周情况.龈沟液中ET水平与TNF-α水平呈显著正相关.PURPOSE: To investigate the effects of basic periodontal treatment on the levels of endothelin (ET), vascular endothelial growth factor-A (VEGF-A) and tumor necrosis factor-α(TNF-α) in gingival crevicular fluid and serum. METHODS: A total of 57 patients with periodontitis (experimental group) and 43 healthy examinees (control group) admitted to Shenzhen Hospital of Guangzhou University of Chinese Medicine from October to May 2018 were selected. Patients received subgingival scaling and root planing for 6 weeks. Then various indexes were compared, including bleeding on probing (BOP), plaque index (PI), probe depth (PD), clinical attachment level (CAL) and gingival index (GI), as well as the levels of ET, VEGF-A and TNF-α in gingival crevicular fluid and serum. The correlation between ET, VEGF-A and TNF-α was analyzed. The data were analyzed with SPSS 21.0 software package. RESULTS: Periodontal indexes including BOP, PI, PD, CAL and GI in the experimental group were significantly increased after treatment (P< 0.05), but still significantly lower than those in the control group (P<0.05). The levels of ET, VEGF-A and TNF-α in gingival crevicular fluid and serum were significantly decreased in the experimental group after treatment (P<0.05), but significantly higher than those in the control group (P <0.05). The level of ET in gingival crevicular fluid was not significantly correlated with VEGF-A level in patients with periodontitis (P>0.05), while was positively correlated with VEGF-A levels (P<0.05). CONCLUSIONS: Basic periodontal treatment can reduce the levels of ET, VEGF-A and TNFa in gingival crevicular fluid and serum of patients with periodontitis, and improve the periodontal status;moreover, ET level in gingival crevicular fluid is positively correlated with TNF-α level.

关 键 词：牙周病 非手术性治疗 龈沟液 ET VEGF-A TNF-Α 

分 类 号：R781.4[医药卫生—口腔医学]