2型糖尿病合并慢性牙周炎患者糖化血红蛋白水平变化与抗菌治疗预后的相关性分析  

Analysis of the correlation between the changes of glycosylated hemoglobin and the prognosis of antibacterial therapy in patients with type 2 diabetes mellitus complicated with chronic periodontitis

作　　者：周丽芝[1] 韩炎 郭谊 ZHOU Lizhi;HAN Yan;GUO Yi(Department of Stomatology,the Eighth Hospital of Tangshan,Tangshan Hebei 063000;Department of Stomatology,Wenan County Hospital,Langfang Hebei 065800;Department of Stomatology,Traditional Chinese Medicine Hospital of Tangshan,Tangshan Hebei 063000,China)

机构地区：[1]唐山市第八医院口腔科,河北唐山063000 [2]廊坊市文安县医院口腔科,河北廊坊065800 [3]唐山市中医医院口腔科,河北唐山063000

出　　处：《新疆医科大学学报》2021年第2期215-219,共5页Journal of Xinjiang Medical University

基　　金：廊坊市科技支撑计划项目(2018013150);河北省自然科学基金(H20182384721)。

摘　　要：目的观察并分析2型糖尿病合并慢性牙周炎患者糖化血红蛋白水平变化与牙周综合抗菌治疗预后的相关性。方法收集2016年4月—2019年7月唐山市第八医院口腔科收治的104例2型糖尿病合并慢性牙周炎患者的临床资料。所有患者均接受牙周综合抗菌治疗,分别于治疗前后测定空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(hemoglobin A1c,HbA1c)水平,并记录治疗后的牙周附着丧失(attachment loss,AL)、探诊出血指数(bleeding on probing,BOP)、菌斑指数(plaque index,PLI)、牙周探诊深度(probing depth,PD)等牙周临床指标并进行比较。结果与治疗前相比,接受治疗后患者的AL、BOP、PLI、PD等指标水平均明显下降,差异均有统计学意义(P<0.05),接受治疗后,与治疗前相比,接受治疗后患者的FBG及HbA1c等指标水平均明显下降,差异均有统计学意义(P<0.05),治疗前后患者AL、BOP、PLI、PD等指标与HbA1c的水平变化明显(P<0.05),BOP与FBG呈正相关,多元回归分析结果显示控制性别、年龄等混杂因素后,AL、BOP、PLI与HbA1c的变化幅度呈正相关(P<0.05)。结论牙周综合抗菌治疗能够明显降低2型糖尿病合并慢性牙周炎患者HbA1c水平,并且其变化幅度与AL、BOP、PLI等指标呈正相关;HbA1c水平检测有望成为评估糖尿病伴牙周炎患者诊断及预后的重要指标。Objective To observe and analyze the correlation between the change of glycosylated hemoglobin level and the prognosis of periodontal comprehensive antimicrobial therapy in the patients with type 2 diabetes mellitus complicated with chronic periodontitis.Methods The clinical data of 104 patients with type 2 diabetes complicated with chronic periodontitis admitted to our hospital from April 2016 to July 2019 were collected.All patients received periodontal comprehensive antimicrobial therapy.Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c)levels were measured before and after treatment,and periodontal attachment loss(AL),probing hemorrhage index(BOP),plaque index(PLI),periodontal probing depth(PD)and other periodontal clinical indicators were recorded.Results Compared with those before the treatment,the levels of AL,BOP,PLI and PD decreased significantly after the treatment(P<0.05),and the levels of FBG and HbA1c decreased significantly after the treatment(P<0.05).Before and after the treatment,the changes of AL,BOP,PLI,PD and other indexes were positively correlated with the level of HbA1c,but only BOP was positively correlated with FBG(P<0.05).The results of multiple regression analysis showed that after controlling the confounding factors such as sex and age,the changes of AL,BOP and PLI were independently positively correlated to HbA1c(P<0.05).Conclusion Combined periodontal antibacterial therapy can significantly reduce the level of HbA1c in the patients with type 2 diabetes complicated with chronic periodontitis,and the change range is independently and positively correlated to AL,BOP,PLI and other indicators,suggesting that the detection of HbA1c level is expected to be an important indicator for the diagnosis and prognosis of patients with diabetes complicated with periodontitis.

关 键 词：糖尿病 2型 牙周炎 糖化血红蛋白 牙龈 血糖 

分 类 号：R781.4[医药卫生—口腔医学]