慢性牙周炎患者炎症程度、抗氧化、胰岛素抵抗及骨代谢的变化分析
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摘要
目的:探讨慢性牙周炎患者炎症程度、抗氧化、胰岛素抵抗及骨代谢的水平变化及临床意义。方法:选择在我院治疗的50例慢性牙周炎患者作为观察组,选取50例同期牙周健康者作为对照组,观察比较两组炎症程度[包括巨噬细胞移动抑制因子(MIF)、单核细胞趋化蛋白-1(MCP-1)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)]、抗氧化[包括一氧化氮(NO)、一氧化氮合酶(NOS)]、胰岛素抵抗[包括脂联素(APN)、瘦素(LEP)]及骨代谢[包括内脂素(Visfatin)、降钙素基因相关肽(CGRP)]相关指标的表达水平。结果:观察组APN及CGRP水平显著低于对照组(P<0.05),MIF、MCP-1、GM-CSF、NO、NOS、LEP及Visfatin水平均显著高于对照组,差异有统计学意义(P<0.05)。结论:慢性牙周炎患者容易出现炎症反应,炎症程度较深;易激起抗氧化效应,抵抗牙周感染;还有可能加重胰岛素抵抗,升高血糖;或是影响骨代谢,出现骨质疏松。
Objective:To investigate the changes and clinical significance of inflammation,antioxidation,insulin resistance and bone metabolism in patients with chronic periodontitis.Methods:A total of 50 patients with chronic periodontitis treated in our hospital from January 2017 to March 2018 were selected as the observation group and a total of 50 cases of periodontal health were selected as control group.The expression levels of related indicators of inflammation which include macrophage migration inhibitory factor (MIF),monocyte chemoattractant protein-1 (MCP-1),granulocyte-macrophage colony-stimulating factor (GM-CSF),antioxidant which include nitric oxide (NO) and nitric oxide synthase (NOS)],insulin resistance[including adiponectin,leptin (LEP)]and bone metabolism[including visfatin and calcitonin gene-related peptide (CGRP)]in the two groups were observed and compared.Results:The levels of adiponectin and CGRP in the observation group were significantly lower than those in the control group (P<0.05).The levels of MIF,MCP-1,GM-CSF NO,NOS,LEP and visfatin were significantly higher than those in the control group.All above differences were significant (P<0.05).Conclusions:Patients with chronic periodontitis are prone to inflammatory reaction.And the degree of inflammation is deeper.It is easy to stimulate antioxidant effect and resist periodontal infection.It may also aggravate insulin resistance to increase blood sugar,or affect bone metabolism and osteoporosis.
Objective:To investigate the changes and clinical significance of inflammation,antioxidation,insulin resistance and bone metabolism in patients with chronic periodontitis.Methods:A total of 50 patients with chronic periodontitis treated in our hospital from January 2017 to March 2018 were selected as the observation group and a total of 50 cases of periodontal health were selected as control group.The expression levels of related indicators of inflammation which include macrophage migration inhibitory factor (MIF),monocyte chemoattractant protein-1 (MCP-1),granulocyte-macrophage colony-stimulating factor (GM-CSF),antioxidant which include nitric oxide (NO) and nitric oxide synthase (NOS)],insulin resistance[including adiponectin,leptin (LEP)]and bone metabolism[including visfatin and calcitonin gene-related peptide (CGRP)]in the two groups were observed and compared.Results:The levels of adiponectin and CGRP in the observation group were significantly lower than those in the control group (P<0.05).The levels of MIF,MCP-1,GM-CSF NO,NOS,LEP and visfatin were significantly higher than those in the control group.All above differences were significant (P<0.05).Conclusions:Patients with chronic periodontitis are prone to inflammatory reaction.And the degree of inflammation is deeper.It is easy to stimulate antioxidant effect and resist periodontal infection.It may also aggravate insulin resistance to increase blood sugar,or affect bone metabolism and osteoporosis.
引文
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12薛媛,赵文峰,刘继延.慢性牙周炎牙周基础治疗前后血清超敏C反应蛋白与单核细胞趋化蛋白-1变化研究[J].中国实用口腔科杂志,2018,11(2):84-87.
13杨宏宇.侵袭性牙周炎患者治疗前后血清GM-CSF、IL-2和CGRP水平检测的临床意义[J].淮海医药,2013,31(6):493-494.
14杨宏宇,梁文学.慢性牙周炎患者治疗后血清细胞因子降低的临床意义[J].黑龙江医药科学,2015,38(6):71-72.
15 Nguyen CM,Kim JW,Quan VH,et al.Periodontal associations in cardiovascular diseases:The latest evidence and understanding[J].Journal of Oral Biology&Craniofacial Research,2015,5(3):203.
16何奕多.TNF-α对脂联素多聚化修饰及分泌调控的研究[D].华中农业大学,2015.
17徐正茂,刘敏,田立华.难治性牙周炎患者血清中瘦素(LEP)水平及其与牙周临床指数关系分析[J].口腔医学研究,2016,32(7):760-763.
18陈飞,史金先,焦鹏,等.牙周炎患者血清中内脂素和PGE2水平检测及其与牙周炎活动性的关系[J].吉林大学学报(医学版),2018,44(3):563-567.
19 Chen Z,Zhao GH,Zhang YK,et al.Research on the correlation of diabetes mellitus complicated with osteoporosis with lipid metabolism,adipokines and inflammatory factors and its regression analysis[J].Eur Rev Med Pharmacol Sci,2017,21(17):3900-3905.
20晏莺,向学熔,王春,等.慢性牙周炎患者治疗前、后血清降钙素基因相关肽水平检测的临床意义[J].上海口腔医学,2016,25(4):448-452.
2 Provenzano JC,Antunes HS,Alves FR,et al.Host-bacterial interactions in post-treatment apical periodontitis:A metaproteome analysis[J].Journal of Endodontics,2016,42(6):880-885.
3赵博,王永兰.糖尿病牙周炎昆明系模型小鼠牙周组织中脂联素的表达[J].中国组织工程研究,2015,19(5):721-726.
4吴芷芸,高秀秋.2型糖尿病牙周炎患者血清瘦素水平与牙周临床指标的相关性研究[J].实用口腔医学杂志,2015,31(4):511-514.
5 Kalburgi V,Sravya L,Warad S,et al.Role of systemic markers in periodontal diseases:apossible inflammatory burden and risk factor for cardiovascular diseases?[J].Annals of Medical and Health Sciences Research,2014,4(3):388-392.
6 Casanova L,Hughes FJ,Preshaw PM.Diabetes and periodontal disease:a two-way relationship[J].British Dental Journal,2014,217(8):433-437.
7 Kalra M,Tangade P,Punia H,et al.Assessment of two-way relationship between periodontal disease and gestational diabetes mellitus:A case-control study[J].Indian Journal of Dental Research,2016,27(4):392.
8徐秋芳,潘佳雨,侯敬雅,等.巨噬细胞移动抑制因子在慢性牙周炎患者血清及牙龈组织中的表达分析[J].中国实用口腔科杂志,2018,11(4):229-233.
9 Dutzan N,Konkel JE,Greenwellwild T,et al.Characterization of the human immune cell network at the gingival barrier[J].Mucosal Immunology,2016,9(5):1163.
10 Ge X,Liu YF,Wong Y,et al.Impact of nicotine on the interplay between human periodontal ligament cells and CD4+T cells[J].Human&Experimental Toxicology,2016,35(9):983.
11 Herenius MMJ,Oliveira ASF,Wijbrandts CA,et al.Anti-TNF therapy reduces serum levels of chemerin in rheumatoid arthritis:A new mechanism by which AntiTNF might reduce inflammation[J].Plos One,2013,8(2):e57802.
12薛媛,赵文峰,刘继延.慢性牙周炎牙周基础治疗前后血清超敏C反应蛋白与单核细胞趋化蛋白-1变化研究[J].中国实用口腔科杂志,2018,11(2):84-87.
13杨宏宇.侵袭性牙周炎患者治疗前后血清GM-CSF、IL-2和CGRP水平检测的临床意义[J].淮海医药,2013,31(6):493-494.
14杨宏宇,梁文学.慢性牙周炎患者治疗后血清细胞因子降低的临床意义[J].黑龙江医药科学,2015,38(6):71-72.
15 Nguyen CM,Kim JW,Quan VH,et al.Periodontal associations in cardiovascular diseases:The latest evidence and understanding[J].Journal of Oral Biology&Craniofacial Research,2015,5(3):203.
16何奕多.TNF-α对脂联素多聚化修饰及分泌调控的研究[D].华中农业大学,2015.
17徐正茂,刘敏,田立华.难治性牙周炎患者血清中瘦素(LEP)水平及其与牙周临床指数关系分析[J].口腔医学研究,2016,32(7):760-763.
18陈飞,史金先,焦鹏,等.牙周炎患者血清中内脂素和PGE2水平检测及其与牙周炎活动性的关系[J].吉林大学学报(医学版),2018,44(3):563-567.
19 Chen Z,Zhao GH,Zhang YK,et al.Research on the correlation of diabetes mellitus complicated with osteoporosis with lipid metabolism,adipokines and inflammatory factors and its regression analysis[J].Eur Rev Med Pharmacol Sci,2017,21(17):3900-3905.
20晏莺,向学熔,王春,等.慢性牙周炎患者治疗前、后血清降钙素基因相关肽水平检测的临床意义[J].上海口腔医学,2016,25(4):448-452.