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作 者:顾晓雯 孙舒君[1] GU Xiao-wen;SUN Shu-jun(Blood Center,Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200025,China)
机构地区:[1]上海交通大学医学院附属瑞金医院血液中心,上海200025
出 处:《解放军医药杂志》2021年第7期15-18,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基 金:瑞金医院院级课题(RJHK-2019-12)。
摘 要:目的分析多发性骨髓瘤(MM)血液透析患者口腔卫生环境,并探讨患者口腔卫生环境与微炎症、营养状态间的关系。方法选取2018年2月—2020年2月本院收治的MM血液透析120例(患者组)及体检健康者120例(对照组),比较2组牙周病患病率、软垢指数(DI)、牙石指数(CI)、牙周病指数(PDI)。根据PDI又将患者组分为牙周病亚组(PDI≥3)和牙周健康亚组(PDI<3),比较牙周病亚组、牙周健康亚组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及血红蛋白、白蛋白、前白蛋白水平。并进一步分析MM血液透析患者牙周情况与微炎症、营养状态的相关性。结果患者组牙周病患病率、DI、CI、PDI均高于对照组(P<0.01)。牙周病亚组血清TNF-α、IL-6及hs-CRP水平均高于牙周健康亚组,血红蛋白、白蛋白、前白蛋白水平均低于牙周健康亚组,差异有统计学意义(P<0.01)。MM血液透析患者牙周病与微炎症指标TNF-α、IL-6、hs-CRP均呈正相关(r=0.382、0.421、0.395,P<0.01),与营养状态指标血红蛋白、白蛋白、前白蛋白均呈负相关(r=-0.404、-0.440、-4.332,P<0.01)。结论MM血液透析患者口腔卫生环境较差,牙周炎发病率较高,且口腔卫生环境与机体微炎症、营养状态密切相关。Objective To analyze the oral health environment and to explore its correlations with microinflammation and nutritional status in patients with multiple myeloma(MM)undergoing hemodialysis.Methods A total of 120 MM patients undergoing hemodialysis(patient group)and 120 healthy people with physical examinations(control group)between February 2018 and February 2020 were selected,and values of periodontal disease prevalence,debris index(DI),calculus index(CI)and periodontal disease index(PDI)were compared between two groups.Patient group was divided into periodontal disease subgroup(PDI≥3)and periodontal health subgroup(PDI<3)according to PDI level.Levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high sensitivity C-reactive protein(hs-CRP),hemoglobin,albumin and prealbumin were compared between periodontal disease and periodontal health subgroups.Correlations between periodontal condition with microinflammation and nutritional status of MM patients undergoing hemodialysis were further analyzed.Results Values of periodontal disease prevalence,DI,CI and PDI in patient group were significantly higher than those in control group(P<0.01).In periodontal disease subgroup,levels of serum TNF-α,IL-6 and hs-CRP were significantly higher,while levels of hemoglobin,albumin and prealbumin were significantly lower than those in periodontal health subgroup(P<0.01).Periodontal disease was positively correlated with TNF-α,IL-6 and hs-CRP in MM patients undergoing hemodialysis(r=0.382,0.421,0.395,P<0.01),and it negatively correlated with hemoglobin,albumin and prealbumin(r=-0.404,-0.440,-4.332,P<0.01).Conclusion Oral hygiene environment of MM patients undergoing hemodialysis is poor with high incidence rate of periodontitis,and oral hygiene environment is closely related to microinflammation and nutritional state.
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