Nd:YAG激光对于根尖周炎中粪肠球菌的作用  

Effect of Nd:YAG laser on Enterococcus faecalis in periapical periodontitis

作　　者：刘沙 许万朋 王倩[1] LIU Sha;XU Wanpeng;WANG Qian(School of Stomatology,Dalian Medical University,Dalian,Liaoning 116044,China)

机构地区：[1]大连医科大学口腔医学院,辽宁大连116044

出　　处：《中国微生态学杂志》2024年第10期1180-1186,共7页Chinese Journal of Microecology

基　　金：2022年国家级大学生创新创业训练计划项目(202210161015);2024年校级大学生创新创业训练计划项目(X202410161057)。

摘　　要：目的 探讨掺钕钇铝石榴石(Nd:YAG)激光对于根尖周炎中粪肠球菌检出率与毒力因子的作用以及Nd:YAG激光对粪肠球菌脂磷壁酸(LTA)刺激下成纤维细胞的IL-1β、IL-6、MMP-2及MMP-9基因和蛋白的作用。方法 选取64名根管治疗患者的70颗患牙,随机分为两组,每组35颗患牙。对照组为常规根管治疗,试验组为Nd:YAG激光辅助根管治疗。其中每组10颗患牙采用激光共聚焦显微镜检测根管治疗前后绿色信号强度比例。每组25颗患牙采用real time PCR检测粪肠球菌的检出率以及毒力因子gelE、cylA、esp的基因表达情况。10μg/mL的LTA和Nd:YAG激光作用于L929细胞12 h后,分为对照组、LTA组及LTA-YAG组,检测L929细胞的IL-1β、 IL-6、 TNF-α、 MMP-2及MMP-9基因和蛋白表达情况。结果激光共聚焦显微镜检测显示,对照组绿色信号强度比例为48.43±6.03,试验组绿色信号强度比例为33.64±10.82,试验组绿色信号强度比例低于对照组,差异有统计学意义(t=15.631,P<0.000 1)。Real time PCR结果显示经过根管预备及消毒后,对照组粪肠球菌检出率为48%,试验组粪肠球菌检出率为28%。Real time PCR检测试验组gelE和cylA的基因相对表达量低于对照组(t=8.930,P=0.021 2;t=13.980,P=0.0021),esp的基因相对表达量高于对照组,差异有统计学意义(t=11.920,P=0.018 9)。10μg/mL的LTA和Nd:YAG激光作用于L929细胞12 h时后,LTA-YAG组IL-1β、IL-6、TNF-α、MMP-2及MMP-9基因相对表达量低于LTA组(t=3.897,P=0.020 0;t=2.812,P=0.048 0;t=5.214,P=0.070 0;t=3.205,P=0.003 0;t=2.812,P=0.048 0),LTA-YAG组炎性因子蛋白相对表达量也低于LTA组(t=3.897,P=0.020 0;t=2.812,P=0.048 0;t=5.214,P=0.070 0;t=3.205,P=0.003 0;t=2.812,P=0.048 0)。结论 Nd:YAG激光可以降低根尖周炎中粪肠球菌的活细菌量,并且可以降低粪肠球菌毒力因子gelE和cylA的基因表达量。Nd:YAG激光可以降低粪肠球菌LTA引起的炎性因子基因和蛋白相对表达量。Objective To observe the effects of Nd:YAG laser on the detection rate and virulence factors of Enterococcus faecalis in periapical periodontitis and on the IL-1β,IL-6,MMP-2 and MMP-9 genes and proteins of fibroblasts stimulated by Enterococcus faecalis lipoteichoic acid(LTA).Methods A total of 70 teeth from 64 patients who underwent root canal treatment were randomly divided into two groups,with 35 teeth in each group.The control group received conventional root canal treatment,while the observation group received Nd:YAG laser-assisted root canal treatment.In each group,10 teeth were treated with laser confocal microscopy to detect the ratio of green signal intensity before and after root canal treatment.Real time PCR was used to detect the detection rate of Enterococcus faecalis and the gene expression of its virulence factors gelE,cylA and esp in 25 teeth in each group.After 10 μg/mL LTA and Nd:YAG laser were applied to L929 cells for 12 hours,the cells were divided into control group,LTA group and LTA-YAG group,and the gene and protein expressions of IL-1β,IL-6,TNF-α,MMP-2 and MMP-9 in L929 cells were detected.Results The results of laser confocal microscopy showed that the green signal intensity ratio in the control group was 48.43±6.03,and that in the observation group was 33.64±10.82.The green signal intensity ratio in the observation group was lower than that in the control group.The differences were statistically significant(t=15.631,P<0.000 1).Real time PCR results showed that after root canal preparation and disinfection,the detection rate of Enterococcus faecalis in the control group was 48%,and that in the observation group was 28%.Real time PCR detected that gelE and cylA in the observation group were lower than those in the control group(t=8.930,P=0.021 2;t=13.980,P=0.002 1);the relative gene expression of esp was higher than that in the control group,and the differences were statistically significant(t=11.920,P=0.018 9).After 10 μg/mL LTA and Nd:YAG laser were applied to L929 cells for 12 h

关 键 词：根尖周炎 粪肠球菌 毒力因子 ND:YAG激光 

分 类 号：R781.34[医药卫生—口腔医学]