中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2013, Vol. 42 ›› Issue (11): 1012–1015.

• 论著 • 上一篇    下一篇

牙周非手术治疗对2型糖尿病伴牙周炎患者牙周致病菌及糖化血红蛋白的影响

寇育荣1,2,李倩1,王宏岩2,潘春玲2,潘亚萍1,2   

  1. 中国医科大学口腔医学院1.口腔生物学教研室;
    2.牙周科,沈阳110002
  • 收稿日期:2013-09-10 出版日期:2013-11-30 发布日期:2013-11-28
  • 作者简介:寇育荣(1973-),女,副教授,博士.
  • 基金资助:
    辽宁省自然科学基金(201202294)

Effects of Periodontal Non-surgical Therapy on Periodontal Pathogens and Glycated Hemoglobin in Patients with Type 2 Diabetes Mellitus Complicated with Periodontitis

KOU Yu-rong1,2,LI Qian1,WANG Hong-yan2,PAN Chun-ling2,PAN Ya-ping1,2   

  1. 1. Department of Oral Biology,School of Stomatology,China Medical University,Shenyang 110002,China;
    2. Department of Periodontology,School of Stomatology,China Medical University,Shenyang 110002,China
  • Received:2013-09-10 Online:2013-11-30 Published:2013-11-28

摘要: 目的从微生物学角度探讨牙周非手术治疗对糖尿病(DM)的影响及其可能机制。方法25名2型DM伴牙周炎患者接受牙周非手术治疗,在基线及治疗后2周、4周、3个月和6个月检测探诊出血、牙周袋深度等牙周临床指数和糖化血红蛋白(HbA1c)等血糖代谢指标,同时采用PCR检测龈下菌斑中牙龈卟啉单胞菌(P.gingivalis)等牙周致病菌。结果25例患者经牙周非手术治疗牙周临床指数均较基线时有明显改善(P<0.05),P.gingivalis等牙周致病菌的检出率均显著下降(P<0.05),尤其fimA#x02160;b型和#x02161;型P.gingivalis的检出率在治疗后显著降低(P<0.05)。HbA1c治疗后无显著改善(P>0.05),但血糖升高者的P.gingivalis检出率显著高于血糖降低者的P.gingivalis检出率(P<0.05),并且fimA#x02161;型P.gingivalis仅能在血糖升高者的龈下菌斑中检出。结论牙周非手术治疗可减少2型DM患者龈下菌群中牙周致病菌的数量,改善牙周状态,2型DM患者血糖控制不良可能与P.gingivalis,尤其是fimA#x02161;型P.gingivalis的存在有关。

关键词: 牙周炎, 2型糖尿病, 牙龈卟啉单胞菌

Abstract: Objective To investigate the effects of periodontal non-surgical therapy on diabetes mellitus,and explore its possible mechanism from the perspective of microbiology. Methods Twenty-five type 2 diabetes mellitus (DM) patients complicated with chronic periodontitis were recruited and treated with periodontal non-surgical therapy. Clinical periodontal index including pocket depth (PD),bleeding on probing (BOP) and metabolic parameters of glycated hemoglobin (HbA1c) were determined at baseline and various time-points for 6 months following treatment. Periodontal pathogens such as Porphyromonas gingivalis(P. gingivalis) in subgingival plaque were detected by a polymerase chain reaction method. Results In 25 patients,clinical periodontal index after non-surgical therapy were significantly improved compared with the baseline (P<0.05). The bacterial detection rate of periodontal pathogens including P. gingivalis,especially that of P. gingivaliswith type #x02161; fimA gene,decreased markedly (P<0.05). The difference of HbA1c after therapy is not statistically significant (P>0.05). However,P. gingivaliswas detected more frequently in subjects with increased HbA1c values after periodontal treatment than in those patients with decreased HbA1c values (P<0.05). P. gingivaliswith type #x02161; fimA genotype was detected only in HbA1c-increased subjects. Conclusion Periodontal non-surgical therapy could reduce the amount of periodontal pathogens in subgingival plaque from patients with DM complicated with chronic periodontitis and improve the periodontal condition. The poorly controlled glycemic level may be related to the presence of P. gingivalis,especially P. gingivaliswith type #x02161; fimA genotype.

Key words: periodontitis, type 2 diabetes mellitus, Porphyromonas gingivalis

[1] Aemaimanan P, Amimanan P, Taweechaisupapong S. Quantification of key periodontal pathogens in insulin-dependent type 2 diabetic and non-diabetic patients with generalized chronic periodontitis[J]. Anaerobe, 2013, 22(8): 64-68.
[2] Ojima M, Takeda M, Yoshioka H, et al. Relationship of periodontal bacterium genotypic variations with periodontitis in type 2 diabetic patients[J]. Diabetes Care, 2005, 28(2): 433-434.
[3] Amano A, Kishima T, Akiyama S, et al. Relationship of periodontopathic bacteria with earlyonset periodontitis in Down#x02019;s syndrome[J]. J Periodontol, 2001, 72(3): 368-373.
[4] Nakagawa I, Amano A, Ohara-Nemoto Y, et al. Identification of a new variant of fimA gene of Porphyromonas gingivalis and its distribution in adults and disabled populations with periodontitis[J]. J Periodontal Res, 2002, 37(6): 425-432.
[5] Jimenez M, Hu FB, Marino M, et al. Type 2 diabetes mellitus and 20 year incidence of periodontitis and tooth loss[J]. Diabetes Res Clin Pract, 2012, 98(3): 494-500.
[6] Silvestre FJ, Miralles L, Llambes F, et al. Type 1 diabetes mellitus and periodontal disease: relationship to different clinical variables[J]. Med Oral Patol Oral Cir Bucal, 2009, 14(4): 175-179.
[7] Gurav AN. Periodontitis and insulin resistance: casual or causal relationship? [J] Diabetes Metab J, 2012, 36(6):404-411.
[8] Inaba H, Amano A. Roles of oral bacteria in cardiovascular diseases from molecular mechanisms to clinical cases: Implication of periodontal diseases in development of systemic diseases [J]. J Pharmacol Sci, 2010, 113(2): 103-109.
[9] Sgolastra F, Severino M, Pietropaoli D, et al. Effectiveness of periodontal treatment to improve metabolic control in patients with chronic periodontitis and type 2 diabetes: a meta-analysis of randomized clinical trials[J]. J Periodontol, 2013, 84(7): 958-973.
[10] Nakano K, Kuboniwa M, Nakagawa I, et al. Comparison of inflammatory changes caused by Porphyromonas gingivalis with distinct fimA genotypes in a mouse abscess model[J]. Oral Microbiol Immunol, 2004, 19(3): 205-209.
[11] 潘春玲, 刘俊超, 潘亚萍, 等. 牙龈卟啉单胞菌对人牙周膜成纤维细胞MMP-1和TIMP-1表达影响的研究[J]. 中国实用口腔科杂志, 2012, 5(4): 210-213.
[1] 李敏, 刘静, 王晓黎, 左迪, 安娜, 刘畅, 宋清斌. 个体化糖尿病教育对初次使用胰岛素的2型糖尿病患者的疗效评价[J]. 中国医科大学学报, 2018, 47(10): 954-957.
[2] 谭昭, 李文歌. 2型糖尿病患者血清尿酸及尿微量白蛋白水平与慢性血管并发症的相关性[J]. 中国医科大学学报, 2018, 47(1): 67-72.
[3] 高明,孟田甜. 纤维带固定术治疗重症牙周炎单颗切牙缺失的疗效分析[J]. 中国医科大学学报, 2017, 46(3): 273-277.
[4] 胥丹妮, 靳赢, 王越, 宋利明, 林晓萍. 肥胖伴牙周炎患者龈沟液及血清中脂联素与内脂素的表达[J]. 中国医科大学学报, 2017, 46(12): 1129-1132,1137.
[5] 庄晓彤,陆美子,于秀玲,徐丽. 东北地区GLIS3基因多态性与2型糖尿病合并视网膜病变的 关联性研究[J]. 中国医科大学学报, 2017, 46(10): 909-912.
[6] 潘春玲,韩伶娜,宋佳,王宏岩,潘亚萍,钟鸣. NLRP3在牙龈卟啉单胞菌感染牙周膜细胞中的表达[J]. 中国医科大学学报, 2016, 45(3): 201-204.
[7] 王芬,方团育,陈开宁,全会标. 2型糖尿病抑郁症患者自我管理水平及抑郁心理发生的相关因素[J]. 中国医科大学学报, 2016, 45(1): 53-55.
[8] 郭丹,吴波. 亚甲减与2型糖尿病微血管病变的相关性[J]. 中国医科大学学报, 2015, 44(8): 730-733.
[9] 刘阳, 王占友, 池志宏, 王涛. SLC30A8基因rs13266634 C/T单核苷酸多态性与2型糖尿病易感性的相关性研究[J]. 中国医科大学学报, 2015, 44(6): 494-497.
[10] 崔洪雨,梁馨予,卢怡君,王鹏,刘学政. 小檗碱对2型糖尿病大鼠局部脑缺血组织中AQP4表达的影响[J]. 中国医科大学学报, 2015, 44(12): 1102-1105.
[11] 张新,周玉红,白云. 自体脂肪干细胞移植治疗2型糖尿病的安全性及有效性[J]. 中国医科大学学报, 2015, 44(12): 1137-1141.
[12] 王薇,王露,郭丹,索琳娜,张微. 利拉鲁肽对肥胖2型糖尿病患者MDA、GSH?Px水平的影响[J]. 中国医科大学学报, 2015, 44(1): 84-85.
[13] 张纳,杨智航,项明慧,杨军. 超声评价2型糖尿病患者颈动脉病变与视网膜微血管病变相关性研究[J]. 中国医科大学学报, 2014, 43(8): 728-732.
[14] 王琳源,关宁,林晓萍,孙晓菊. 全反式维甲酸对牙周炎小鼠辅助性T17细胞和调节性T细胞及细胞相关因子表达的影响[J]. 中国医科大学学报, 2014, 43(7): 606-611.
[15] 王楚媛,孔令芳,侯永生,柳越,张洋. 脂联素与2型糖尿病进程的相关性[J]. 中国医科大学学报, 2014, 43(5): 429-431.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!

中国医科大学学报版权所有©2018

未经允许,严禁擅自转载本站图文资料

地址:中国 沈阳市沈北新区蒲河路77号 110122

辽ICP备05014850

JOURNAL OF CHINA MEDICAL UNIVERSITY

ADDRESS: NO.77 PUHE ROAD

SHENYANG NORTH NEW AREA, SHENYANG

LIAONING PROVINCE, P.R. CHINA