血小板与牙周炎相关性的研究进展  

Research progress on the relationship between platelets and periodontitis

作　　者：张义涛 程瑞[2] 米仲乾 任秀云[1] ZHANG Yitao;CHENG Rui;MI Zhongqian;REN Xiuyun(Shanxi Medical University School and Hospital of Stomatology,Taiyuan 030001,China;The Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学口腔医学院·口腔医院,山西太原030001 [2]山西医科大学第二医院,山西太原030001

出　　处：《口腔疾病防治》2024年第12期984-990,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：山西省中央引导地方科技发展基金项目(YDZX202014000011310);山西省高等学校科技创新计划项目(2022L145)。

摘　　要：血小板是血液循环中的小细胞碎片,除了与止血和血栓形成密切相关外,还参与了免疫炎症反应,在炎症中发挥着重要作用。牙周炎是由牙周致病菌感染引起的慢性炎症性疾病,造成了局部和全身的炎症反应,与许多全身疾病的发展有关。近年来,许多以动物和人体为对象的研究从血液、牙龈和龈沟液3个方面证明了牙周炎与血小板的相关性,并且发现活化的血小板在牙周炎的发生发展中起着十分重要的作用,可能的机制是牙龈卟啉单胞菌(Porphyromonas gingivalis,P.g)和炎症介质S100A8/A9引起血小板的聚集和活化,活化后的血小板与白细胞结合形成血小板⁃白细胞聚合物并迁移到牙周组织中,产生促炎因子,参与牙周组织的免疫炎症反应,促进牙周炎的发生和发展。研究还表明,牙周基础治疗可降低血小板活化程度,使血小板⁃白细胞聚合物的形成减少,这可能降低牙周炎患者患心血管疾病(cardiovascular disease,CVD)的风险;并且血小板活化抑制药物能够抑制牙周炎症和促进牙周组织修复。此外,P.g诱导的血小板上CD40L的表达还可能是牙周炎与心血管疾病之间的重要介质。因此,血小板作为参与牙周炎发生发展的重要炎症细胞,有望成为一个新的、潜在的治疗靶点。本文主要对牙周炎与血小板相关性的最新研究进展进行综述。Platelets,small cell fragments in the blood that prevent bleeding,are closely associated with hemostasis and thrombosis and play an important role in the inflammatory response.Periodontitis is a chronic inflammatory disease caused by periodontopathogenic bacteria,resulting in local and systemic inflammatory responses that are associated with many systemic diseases.In recent years,several animal and human studies have demonstrated the correlation between periodontitis and platelets from three aspects:gingiva,and gingival crevicular fluid,and found that activated platelets play a very important role in the development and progression of periodontitis.Porphyromonas gingivalis and inflammato⁃ry mediators S100A8/A9 activate platelets,which then combine with leukocytes to form platelet–leukocyte aggregates.These aggregates can migrate into periodontal tissue,producing proinflammatory cytokines,thereby promoting the devel⁃opment and progression of periodontitis.Available studies also suggest that initial periodontal therapy reduces platelet activation and platelet–leukocyte aggregate formation,which may reduce the risk of cardiovascular diseases(CVDs)in patients with periodontitis.Additionally,studies found that antiplatelet drugs can inhibit periodontal inflammation and promote periodontal tissue repair and that P.gingivalis⁃induced expression of CD40L on platelets may be an important mediator between periodontitis and CVD.These reports suggest that platelets can serve as novel therapeutic targets for the treatment of periodontitis.This review aims to discuss the current literature on the correlation and interaction mechanisms between periodontitis and platelets.

关 键 词：牙周炎 血小板 血小板指数 血小板活化 血小板⁃白细胞聚合物 炎症 牙周致病菌 心血管疾病 

分 类 号：R78[医药卫生—口腔医学]