超声龈下刮治联合替硝唑冲洗治疗慢性牙周炎临床疗效及其对龈沟液趋化因子、炎症因子及基质金属蛋白酶影响  

Clinical effect of ultrasonic subgingival curettage combined with tinidazole irrigation on chronic periodontitis and its influence on chemokines,inflammatory factors and matrix metalloproteinases in gingival crevicular fluid

作　　者：唐晓悦 闫虹 张怡萱 曹灿 TANG Xiao-yue;YAN Hong;ZHANG Yi-xuan;CAO Can(Department of Stomatology,General Hospital of Northern Theater Command,Shenyang 110016,China;China Medical University,Shenyang 110001,China)

机构地区：[1]北部战区总医院口腔内科,辽宁沈阳110016 [2]中国医科大学,辽宁沈阳110001

出　　处：《临床军医杂志》2024年第4期374-377,共4页Clinical Journal of Medical Officers

基　　金：辽宁省自然科学基金面上项目(2022-MS-043)。

摘　　要：目的探讨超声龈下刮治联合替硝唑冲洗治疗慢性牙周炎的临床疗效及其对龈沟液趋化因子、炎症因子及基质金属蛋白酶(MMPs)的影响。方法选取北部战区总医院自2018年1月至2019年12月收治的133例慢性牙周炎患者为研究对象。采用随机数字表法将患者分为A组(n=67)与B组(n=66)。A组患者采用无菌蒸馏水冲洗治疗,B组患者应用超声龈下刮治联合替硝唑冲洗治疗。分别于治疗前、治疗后1个月,记录并比较两组患者龈沟液趋化因子[CX3C趋化因子配体1(CX3CL1)、核因子kB受体活化因子配体蛋白(RANKL)、骨保护素(OPG)、RANKL/OPG]、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白细胞介素8(IL-8)]、MMPs(MMP-2、MMP-8、MMP-9)、牙周状况[牙齿松动度(TM)、牙周袋探诊深度(PD)、龈沟出血指数(SBI)、菌斑指数(PLI)]。比较两组患者的临床疗效。结果治疗后,两组患者CX3CL1、RANKL、RANKL/OPG、TNF-α、IL-1β、IL-6、IL-8、MMP-2、MMP-8、MMP-9、TM、PD、SBI、PLI均低于治疗前,且B组均低于A组,差异均有统计学意义(P<0.05)。治疗后,两组患者OPG均高于治疗前,且B组高于A组,差异均有统计学意义(P<0.05)。B组患者治疗的总有效率为90.91%(60/66),高于A组的79.10%(53/67),差异有统计学意义(P<0.05)。结论超声龈下刮治联合替硝唑冲洗治疗慢性牙周炎患者疗效确切,可有效改善其牙周状况。Objective To investigate the clinical efficacy of ultrasonic subgingival curettage combined with tinidazole irrigation in the treatment of chronic periodontitis and its effects on chemokines,inflammatory factors and matrix metalloproteinases(MMPs)in gingival crevicular fluid.Methods A total of 133 patients with chronic periodontal disease admitted to General Hospital of Northern Theater Command from January 2018 to December 2019 were selected as the study objects.Patients were divided into group A(n=67)and group B(n=66)by random number table method.Patients in group A were irrigated with sterile distilled water,and patients in group B were treated with ultrasonic subgingival curettage combined with tinidazole.Before treatment and one month after treatment,the chemokines[CX3C chemokine ligand 1(CX3CL1),ligand of receptor activator of NF-κB(RANKL),osteoprotectin(OPG),RANKL/OPG],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(IL-8)],MMPs(MMP-2,MMP-8,MMP-9),periodontal status[tooth mobility(TM),probing depth(PD),sulcus bleeding index(SBI),plaque index(PLI)].The clinical efficacy of the two groups was compared.Results After treatment,CX3CL1,RANKL,RANKL/OPG,TNF-α,IL-1β,IL-6,IL-8,MMP-2,MMP-8,MMP-9,TM,PD,SBI and PLI in two groups were lower than before treatment,and those in group B were lower than those in group A.The differences were statistically significant(P<0.05).After treatment,OPG in both groups was higher than before treatment,and OPG in group B was higher than that in group A,with statistical significance(P<0.05).The total effective rate of group B was 90.91%(60/66),higher than 79.10%(53/67)of group A,and the difference was statistically significant(P<0.05).Conclusion Ultrasonic subgingival curettage combined with tinidazole irrigation is effective in the treatment of patients with chronic periodontitis and can effectively improve their periodontal status.

关 键 词：慢性牙周炎 超声龈下刮治 替硝唑冲洗 趋化因子 炎症因子 基质金属蛋白酶 

分 类 号：R781.42[医药卫生—口腔医学]