慢性根尖周炎患者根管感染病原学与危险因素及miR-146a-5p、IL-1β、IL-34的预测价值  

Pathogenic distribution and risk factors of root canal infection in patients with chronic periapical inflammation and predictive value of miR-146a-5p,IL-1β and IL-34

作　　者：柯云艳 陈学鹏[2] 张立港[1] 徐巧焱 朱秀明[1] KE Yun-yan;CHEN Xue-peng;ZHANG Li-gang;XU Qiao-yan;ZHU Xiu-ming(Shaoring Traditional Chinese Medicine Hospital,Shaoring,Zhejiang 312000,China;不详)

机构地区：[1]绍兴市中医院口腔科,浙江绍兴312000 [2]浙江大学附属医院口腔科正畸科,浙江杭州310000

出　　处：《中华医院感染学杂志》2023年第23期3620-3624,共5页Chinese Journal of Nosocomiology

基　　金：浙江省基础公益研究计划基金资助项目(LY18H140001);绍兴市科技局基金资助项目(2020A13041)。

摘　　要：目的调查慢性根尖周炎患者根管感染的病原学分布、危险因素,并探讨微小RNA(miR)-146a-5p、白细胞介素(IL)-1β、IL-34对慢性根尖周炎患者根管感染的预测价值。方法回顾性选取94例2018年1月-2022年12月绍兴市中医院收治的慢性根尖周炎患者及101名正畸拔除的健康者为研究对象,分别为研究组和对照组;采集根管组织液进行病原学检查,分析慢性根尖周炎患者根管感染的病原学分布;收集两组患者的临床资料,采用单因素和多因素Logistic法分析慢性根尖周炎患者根管感染的危险因素;利用实时荧光定量聚合酶链式反应(PCR)法检测两组患者牙周组织miR-146a-5p、IL-1β、IL-34的表达水平,并绘制受试者工作特征(ROC)曲线分析其表达单独检测和联合检测对慢性根尖周炎患者根管感染的预测价值。结果94例慢性根尖周炎根管感染患者的根管组织液中共分离出113株病原菌,包括革兰阳性菌63株(55.75%)和革兰阴性菌50株(44.25%);年龄大、饮食喜甜、刷牙时间短、有龋牙、根管填充不良、牙冠修复不良、牙冠填充不良是慢性根尖周炎患者根管感染的危险因素(P<0.05);研究组患者病损牙周组织miR-146a-5p、IL-1β、IL-34的表达水平均高于对照组健康牙周组织(P<0.05),且三者联合检测对慢性根尖周炎患者根管感染预测的曲线下面积(AUC)为0.935,高于单独检测(P<0.05),其敏感度为91.49%,特异度为82.18%。结论慢性根尖周炎患者根管感染的危险因素包括根管填充、牙冠修复和填充不良等,牙周组织miR-146a-5p、IL-1β、IL-34联合检测对慢性根尖周炎患者根管感染预测价值较高,临床可据此结合牙周组织miR-146a-5p、IL-1β、IL-34表达情况给予高危患者针对性的抗菌治疗或干预措施,以减少根管感染的发生。OBJECTIVE To investigate the pathogenic distribution and risk factors of root canal infection in patients with chronic periapical inflammation,and to explore the predictive value of microRNA(miR)-146a-5p,interleukin(IL)-1β,and IL-34 in root canal infection.METHODS A total of 94 patients with chronic periapical periodontitis admitted to Shaoxing Traditional Chinese Medicine Hospital from Jan 2018 to Dec 2022 and 101 healthy volunteers with orthodontic extraction during the same period were retrospectively recruited as the research subjects,which were divided into the study group and the control group.The root canal tissue fluid was collected for pathogenic examination and pathogenic distribution analysis of root canal infection in chronic periapical inflammation patients.The clinical data of the two groups were collected to analyze the high-risk factors for root canal infection in patients with chronic periapical inflammation using univariate and multivariate Logistic methods.Real-time fluorescence quantitative polymerase chain reaction(PCR)was used to detect the expression levels of miR-146a-5p,IL-1β and IL-34 in periodontal tissue of both groups,and the receiver operator characteristic(ROC)curve was drawn to analyze the predictive value of the three detection individual and combined in root canal infection in patients with chronic periapical inflammation.RESULTS A total of 113 strains of pathogenic bacteria were isolated from the root canal fluid of 94 patients with chronic periapical inflammation,including 63 strains of gram-positive bacteria(55.75%)and 50 strains of gram-negative bacteria(44.25%).Old age,sweet diet,short brushing time,dental caries,poor root canal filling,poor crown repair,and poor crown filling were the risk factors for root canal infection in patients with chronic periapical inflammation(P<0.05).The expression levels of miR-146a-5p,IL-1β and IL-34 in damaged periodontal tissue of the study group were higher than those in the healthy periodontal tissue of the control group(P<0.05).And the

关 键 词：慢性根尖周炎 根管感染 病原学 危险因素 微小RNA-146a-5p 白细胞介素-1Β 白细胞介素-34 预测价值 

分 类 号：R781.341[医药卫生—口腔医学]