牙周基础治疗对甲状腺功能减退伴慢性牙周炎患者促甲状腺激素的影响  

Effect of basic periodontal therapy on thyroid-stimulating hormone in patients with hypothyroidism associated with chronic periodontitis

作　　者：邬建华 吴军[2] 郭凤芹[1] WU Jian-hua;WU Jun;GUO Feng-qin(Hefei Stomatological Hospital,Anhui Hefei 230011,China;The Second Affiliated Hospital of Anhui Medical University,Anhui Hefei 230601,China)

机构地区：[1]合肥市口腔医院,安徽合肥230011 [2]安徽医科大学第二附属医院,安徽合肥230601

出　　处：《临床口腔医学杂志》2024年第9期548-551,共4页Journal of Clinical Stomatology

摘　　要：目的:评估牙周基础治疗(nonsurgical periodontal therapy,NSPT)对甲状腺功能减退伴慢性牙周炎患者血清促甲状腺激素(thyroid-stimulating hormone,TSH)水平的影响。方法:纳入42名受试者,其中21例已知甲状腺功能减退伴慢性牙周炎受试者服用相同的左甲状腺素钠片,且TSH在正常范围内(实验组)和21名健康受试者(对照组),评估两组患者在基线以及实验组NSPT前后的临床参数,包括血清TSH水平、简化口腔卫生指数(oral hygiene indexsimplified,OHIS)、牙龈乳头出血指数(papillary bleeding indexm,PBI)、牙周筛查和记录指数(periodontal screening and recording index,PSR)和临床附着丧失(clinical attachment loss,CAL)。采用Pearson相关性分析实验组治疗前血清TSH水平与牙周临床参数的关联。结果:Pearson相关性分析表明实验组治疗前血清TSH平均水平与牙周临床参数呈正相关。基线时,实验组患者TSH水平为(3.49±1.40)μIU/mL,对照组TSH为(2.61±1.10)μIU/mL,差异无统计学意义(P=0.092),但OHI-S、PBI、PSR、CAL临床参数大于对照组(P<0.05)。实验组患者NSPT前后TSH显著降低(P=0.014)、牙周临床指标显著改善(P<0.05)。结论:甲状腺功能减退伴慢性牙周炎患者的TSH水平与牙周临床参数相关,且NSPT改善牙周状况后,可能因炎症因子减少从而降低促甲状腺激素水平。Objective:To evaluate the effect of periodontal primary therapy(NSPT)on serum thyroid-stimulating hormone(TSH)levels in patients with hypothyroidism with chronic periodontitis.Methods:Forty-two subjects were enrolled,that 21 subjects diagnosed with hypothyroidism and chronic periodontitis were given the same thyroid supplement(Levothyroxine Sodium Tablets),the TSH was within the normal range(experimental group),and 21 healthy patients(control group).Clinical parameters including serum TSH levels,oral hygiene indexsimplified(OHIS),papillary bleeding indexm(PBI),periodontal screening and recording index(PSR)and clinical attachment loss(CAL).Pearson's correlation analysis was used to analyse the association between pre-treatment serum TSH levels and periodontal clinical parameters in the experimental group.Results:Pearson correlation analysis showed a positive correlation between the mean serum TSH level and periodontal clinical parameters before treatment in the experimental group.At baseline,the TSH of the patients in the experimental group was(3.49±1.40)μIU/mL and that of the control group was(2.61±1.10)μIU/mL,which was not statistically significant for the two groups(P=0.092),but OHI-S,PBI,PSR,and CAL clinical parameters were greater than those in the control group(P<0.05).Patients in the experimental group had a significant decrease in TSH before and after NSPT(P=0.014)and a significant improvement in periodontal clinical indicators(P<0.05).Conclusion:TSH levels in patients with hypothyroidism with chronic periodontal disease correlate with periodontal clinical parameters,and the improvement of periodontal conditions by NSPT may reduce thyroid stimulating hormone levels due to the reduction of inflammatory factors.

关 键 词：甲状腺功能减退 牙周基础治疗 慢性牙周炎 促甲状腺激素 

分 类 号：R781.4[医药卫生—口腔医学]