急性牙髓炎患者龈沟液中HMGB1和PTX3水平与根管治疗后疼痛程度的关系  

Relationship between the level of HMGB1,PTX3 in gingival crevicular fluid and the pain severity after root canal therapy for acute pulpitis

作　　者：夏振宇 吴霄鹏 李佳妮 Xia Zhenyu;Wu Xiaopeng;Li Jiani(Department of Stomatology,Hepingli Hospital,Beijing 100013)

机构地区：[1]北京市和平里医院口腔科,北京100013

出　　处：《口腔材料器械杂志》2025年第1期27-31,共5页Chinese Journal of Dental Materials and Devices

基　　金：基金资助:北京市东城区科技计划项目(编号:2021-18)。

摘　　要：目的探讨高迁移率族蛋白B1(HMGB1)和正五聚蛋白3(PTX3)在急性牙髓炎患者龈沟液中的表达及其与根管治疗后疼痛程度的关系。方法选取2021年1月至2022年12月期间在本院进行根管治疗的急性牙髓炎患者198例,根据术后7 d的疼痛程度,分为轻度(n=135)、中度(n=42)和重度疼痛组(n=21)。比较三组龈沟液中HMGB1和PTX3的表达水平;多因素Logistic回归分析急性牙髓炎患者根管治疗后疼痛程度的影响因素;ROC曲线分析龈沟液中HMGB1和PTX3水平对急性牙髓炎患者根管治疗后发生中、重度疼痛的预测价值。结果轻、中、重度疼痛组龈沟液中HMGB1和PTX3水平依次升高(P<0.05),且是急性牙髓炎患者根管治疗后疼痛程度的影响因素(P<0.05)。ROC曲线显示,龈沟液中的HMGB1和PTX3两者联合预测急性牙髓炎患者根管治疗后发生中、重度疼痛的AUC为0.934,敏感性为79.37%,特异性为91.85%,优于HMGB1、PTX3各自单独预测价值(Z_(联合检测-HMGB1)=3.823、Z_(联合检测-PTX3)=3.258,P=0.000、0.001)。结论急性牙髓炎患者龈沟液中HMGB1和PTX3水平随根管治疗后疼痛程度增加而升高,两者联合对根管治疗后发生中、重度疼痛具有较好的预测价值。Objective To investigate the expression levels of high mobility group protein B1(HMGB1)and pentraxin-3(PTX3)in the gingival crevicular fluid of patients with acute pulpitis and their association with pain severity following root canal therapy.Methods A total of 198 patients with acute pulpitis who underwent root canal therapy in our hospital from January 2021 to December 2022 were included in this study.Based on pain levels assessed seven days postoperatively,patients were categorized into three groups:mild pain(n=135),moderate pain(n=42),and severe pain(n=21).The expression levels of HMGB1 and PTX3 in gingival crevicular fluid were compared among the three groups.Multivariate logistic regression analysis was used to identify factors influencing pain severity after root canal therapy in patients with acute pulpitis.The predictive value of HMGB1 and PTX3 levels in gingival crevicular fluid for the occurrence of moderate to severe pain following root canal treatment was assessed using receiver operating characteristic(ROC)curve analysis.Results The levels of HMGB1 and PTX3 in gingival crevicular fluid increased progressively across the mild,moderate,and severe pain groups(P<0.05).Root canal filling quality,HMGB1,and PTX3 were identified as significant influencing factors for postoperative pain severity in patients with acute pulpitis(P<0.05).The ROC curv e analysis showed that the combination of HMGB1 and PTX3 in predicting moderate to severe pain yielded an area under the curve(AUC)of 0.934,with a sensitivity of 79.37%and a specificity of 91.85%,which outperfomed the predictive accuracy of HMGB1 or PTX3 alone(Z_(combined detection-HMGB1)=3.823,Z_(combined detection-PTX3)=3.258,P=0.000,0.001).Conclusion The levels of HMGB1 and PTX3 in gingival crevicular fluid increase with the severity of pain after root canal treatment in patients with acute pulpitis.The combined assessment of HMGB1 and PTX3 provides better predictive value for identifying patients at risk of moderate to severe pain following root canal treatment

关 键 词：高迁移率族蛋白B1 正五聚蛋白3 急性牙髓炎 根管治疗 疼痛程度 

分 类 号：R781.31[医药卫生—口腔医学]