牙周基础治疗对体内一氧化氮水平和血压的影响  

Effects of non-surgical periodontal treatment on nitric oxide and blood pressure

作　　者：曹羡梓 付子波 陈佳璐 孙颖[1] CAO Xianzi;FU Zibo;CHEN Jialu;SUN Ying(Department of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China)

机构地区：[1]南京医科大学附属口腔医院牙周科,江苏省口腔疾病研究重点实验室,江苏省口腔转化医学工程研究中心,江苏南京210029

出　　处：《口腔生物医学》2022年第1期30-34,共5页Oral Biomedicine

基　　金：国家自然科学基金(81771075);江苏高校优势学科建设工程资助项目(2018-87)。

摘　　要：目的:探讨牙周基础治疗对一氧化氮(NO)代谢和血压的影响。方法:纳入45名血压正常的中、重度牙周炎患者,记录牙周基础治疗前及治疗后1月患者的菌斑指数、牙龈指数、探诊深度、临床附着丧失(CAL)及血压,采用Griess法测量治疗前后唾液及血浆NO氧化产物亚硝酸钠(NaNO_(2))水平,实时定量PCR技术检测治疗前后龈下菌斑中牙龈卟啉单胞菌(P.gingivalis)、中间普氏菌(P.intermedia)及总菌水平,ELISA法检测治疗前后龈沟液(GCF)和血清中的白介素(IL)-6水平,以及血清C-反应蛋白(CRP)水平,并对治疗前血压、牙周临床指标、细菌数量、NaNO_(2)、CRP、IL-6水平间的关系进行相关性分析。结果:牙周基础治疗后1月,患者各牙周临床指标、血压、唾液及血浆NaNO_(2)水平、龈下菌斑中的P.gingivalis、P.intermedia及总菌水平、血清及GCF中的IL-6及CRP水平均显著下降(P<0.05)。治疗前收缩压与GCF中IL-6水平、唾液NaNO_(2)水平、CAL均存在中度相关性;舒张压与总菌水平、P.intermedia存在中度相关性(P<0.05)。结论:牙周基础治疗能降低唾液及血浆NO水平,同时改善全身炎症状态,为伴高血压的牙周炎患者的治疗提供参考。Objective: The aim of this study was to explore the short-term effects of non-surgical periodontal treatment(NSPT)on NO metabolism and blood pressure control.Methods:Forty-five normotensive patients with periodontitis(stageⅢorⅣand grade B or C)were recruited and received NSPT.Periodontal parameters,including plaque index,gingival index,probing depth,clinical attachment loss(CAL)and blood pressure were recorded before and one month after NSPT.Levels of NO in salivary and plasma were explored by Griess reaction.Quantities of Porphyromonas gingivalis(P.gingivalis),Prevotella intermedia(P.intermedia)and total bacteria in subgingival plaque were determined by real-time PCR.Moreover,levels of C-reactive protein(CRP)in serum and IL-6 in gingival crevicular fluid(GCF)and serum were detected by ELISA.The correlation of blood pressure,periodontal parameters,quantities of bacteria and levels of NaNO_(2),CRP and IL-6 was analyzed.Results:One month after NSPT,periodontal parameters and blood pressure were decreased(P<0.05),and there were lower levels of NO in both saliva and plasma(P<0.05).In addition,NSPT decreased the amounts of total bacteria,P.gingivalis,P.intermedia,and the production of IL-6 and CRP(P<0.05).Moderate correlations were revealed between systolic blood pressure and IL-6 level in GCF,salivary NaNO level and CAL and there was a moderate correlation between diastolic blood pressure and total bacteria level,P.intermedia(P<0.05).Conclusions:NSPT decreased NO levels and suppressed systemic and periodontal inflammations,which provided reference for the treatment of periodontitis patients with hypertension.

关 键 词：牙周基础治疗 牙周炎 高血压 一氧化氮 牙龈卟啉单胞菌 中间普氏菌 

分 类 号：R781.4[医药卫生—口腔医学]