慢性牙周炎患者龈沟液和血清中DKK-1、MIP-1α及IL-17水平及其临床意义  

Levels of DKK-1,MIP-1αand IL-17 in gingival crevicular fluid and serum of patients with chronic periodontitis and their clinical significance

作　　者：贾慧 杨磊 王璞 刘璇[3] 康凯 Jia Hui;Yang Lei;Wang Pu;Liu Xuan;Kang Kai(Department of Periodontology,Handan Stomatological Hospital,Handan 056000,China;Department of Implantology,Handan Stomatological Hospital,Handan 056000,China;Department of Orthodontics,Baoding Second Hospital,Handan 056000,China;Department of Orthodontics,Handan Stomatological Hospital,Handan 056000,China)

机构地区：[1]邯郸市口腔医院牙周科,邯郸056000 [2]邯郸市口腔医院种植科,邯郸056000 [3]保定市第二医院正畸科,邯郸056000 [4]邯郸市口腔医院正畸科,邯郸056000

出　　处：《中国医师杂志》2022年第9期1316-1320,共5页Journal of Chinese Physician

基　　金：河北省2020年度医学科学研究课题计划(20200445)。

摘　　要：目的探讨慢性牙周炎患者龈沟液和血清中龈沟液分泌蛋白(DKK-1)、巨噬细胞炎症蛋白-1α(MIP-1α)及白细胞介素(IL)-17水平及其临床意义。方法前瞻性选取80例慢性牙周炎患者(观察组)及40例牙周健康者(对照组),比较两组牙龈指数(GI)、出血指数(BI)、探针深度(PD)、附着丧失(AL)水平,比较两组龈沟液和血清中的IL-6、IL-8、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、DKK1、MIP-1α、IL-17水平,分析观察组DKK-1、MIP-1α、IL-17水平与牙周指标及炎症因子的相关性,并比较不同病情程度的患者治疗前后的龈沟液和血清中DKK-1、MIP-1α及IL-17水平。结果观察组的GI、BI、PD、AL水平[分别为(2.11±0.36)分、(3.76±0.65)分、(4.56±0.78)mm、(4.06±0.49)mm]均明显高于对照组[分别为(0.53±0.08)分、(1.61±0.33)分、(2.13±0.29)mm、0 mm](均P<0.05)。观察组龈沟液中IL-6、IL-8、TNF-α、DKK-1、MIP-1α、IL-17水平[分别为(65.23±9.30)ng/L、(310.19±42.95)ng/L、(40.46±9.70)ng/L、(13.70±3.62)μg/L、(19.67±8.14)μg/L、(315.84±53.76)pg/μl]均明显高于对照组[分别为(36.81±5.61)ng/L、(178.21±25.73)ng/L、(26.43±5.76)ng/L、(7.41±2.02)μg/L、(6.23±1.99)μg/L、(266.64±46.27)pg/μl](均P<0.05),血清中IL-8、TNF-α、DKK-1、MIP-1α、IL-17水平也高于对照组(均P<0.05)。观察组的龈沟液和血清DKK-1、MIP-1α、IL-17水平均与GI、BI、PD、AL等牙周指标及IL-8、TNF-α水平呈正相关(均P<0.05)。在观察组中,轻度患者的龈沟液和血清DKK-1、MIP-1α及IL-17水平均低于中重度患者,且轻度、中重度患者治疗后的DKK-1、MIP-1α及IL-17水平均低于治疗前,差异均有统计学意义(均P<0.05)。结论慢性牙周炎患者龈沟液和血清DKK-1、MIP-1α及IL-17水平升高,且与慢性牙周炎的发生发展密切相关,检测上述指标对疾病的诊断和治疗有一定意义。Objective To investigate the level of gingival crevicular fluid and serum gingival sulcus fluid Dickkopf-1(DKK-1),macrophage inflammatory protein-1α(MIP-1α)and interleukin(IL)-17 in patients with chronic periodontitis and their clinical significance.Methods 80 patients with chronic periodontitis(observation group)and 40 healthy periodontal subjects(control group)were prospectively selected.The gingival index(GI),bleeding index(BI),probe depth(PD),loss of attachment(AL)levels were compared between the two groups.The IL-6,IL-8,tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),DKK1,MIP-1αand IL-17 levels in the gingival sulcus fluid and serum of the two groups were compared,and the correlation of DKK-1,MIP-1αand IL-17 levels with periodontal indexes and inflammatory factors in the observation group were analyzed.The DKK-1,MIP-1αand IL-17 levels in the gingival crevicular fluid and serum before and after treatment were compared among the patients with different disease degrees.Results The levels of GI,BI,PD and AL in the observation group[(2.11±0.36)points,(3.76±0.65)points,(4.56±0.78)mm,(4.06±0.49)mm,respectively]were higher than those of the control group[(0.53±0.08)points,(1.61±0.33)points,(2.13±0.29)mm,0 mm,respectively](all P<0.05).The levels of IL-6,IL-8,TNF-α,DKK-1,MIP-1αand IL-17 in gingival crevicular fluid of the observation group[(65.23±9.30)ng/L,(310.19±42.95)ng/L,(40.46±9.70)ng/L,(13.70±3.62)μg/L,(19.67±8.14)μg/L,(315.84±53.76)pg/μl]were higher than those of the control group[(36.81±5.61)ng/L,(178.21±25.73)ng/L,(26.43±5.76)ng/L,(7.41±2.02)μg/L,(6.23±1.99)μg/L,(266.64±46.27)pg/μl,respectively](all P<0.05).The serum levels of IL-8,TNF-α,DKK-1,MIP-1αand IL-17 in the observation group were also higher than those in the control group(all P<0.05).In the observation group,the levels of DKK-1,MIP-1αand IL-17 in gingival crevicular fluid and serum were positively correlated with eriodontal indexes(GI,BI,PD,AL)and the IL-8 and TNF-αlevels(all P<0.05).In the observation grou

关 键 词：牙周炎 牙龈缝液 DICKKOPF-1 巨噬细胞炎性蛋白质1α 白细胞介素17 

分 类 号：R781.42[医药卫生—口腔医学]