牙周病与早产及低体质量儿关系的临床研究
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摘要
目的探讨孕妇牙周状况与早产及低体质量儿的关系。方法收集出现先兆早产的孕妇,选择其中出现早产或低体质量新生儿的孕妇50例为早产组,以同期来医院足月待产的孕妇50例为足月产组。所有产妇分娩前均进行全口牙周检查,记录菌斑指数(PLI)、牙石指数(CI)、牙龈出血指数(BI)、牙周探诊深度(PD)及临床附着丧失(CAL)。检测2组孕妇外周血中炎症相关细胞因子肿瘤坏死因子α、前列腺素E2、基质金属蛋白酶-9和C反应蛋白的水平。将分娩孕周及新生儿体质量、牙周状况和外周血细胞因子水平分别做相关性分析。结果与足月产组比较,早产组孕妇的牙周状况较差,PLI,BI,CI及牙周炎患病率均显著升高(P<0.05);孕妇的PLI,BI,CI及牙周炎患病率与分娩孕周及新生儿体质量呈负相关。早产组外周血中炎症相关细胞因子水平均显著高于足月产组;孕妇外周血中细胞因子水平与PLI,BI,CI和牙周炎患病率呈正相关,与分娩孕周及新生儿体质量呈负相关。结论孕妇牙周状况与早产低体质量新生儿间可能存在一定的相关性;牙周状况对早产及低体质量儿的影响可能与外周血中炎症相关细胞因子的改变有关。
Objective To investigate the correlation between periodontal disease and premature and low birth weight infants in pregnant women. Methods One hundred pregnant women were enrolled and divided into control group and experimental group based on whether the new borns were premature or were with low birth weight. The plaque index(PLI),calculus index(CI),gingival bleeding index(BI),probing depth(PD),and clinical attachment loss(CAL)were recorded. And the peripheral blood levels of TNF-α,PGE2,MMP-9,and CRP were detected using enzyme-linked immunoassays. Correlation analysis between the pregnancy,low birth weight infants,periodontal status,and the peripheral blood cytokine in two groups were detected. Results Periodontal status in experimental group were worse than that of pregnant women in control group. The PLI,BI,CI,prevalence of periodontitis,and inflammatory cytokines level in peripheral blood in experimental group were higher than control group(P<0.05).And the PLI,BI,CI,and the prevalence of periodontitis in pregnant women were negatively correlated with premature and low birth weight infants. The inflammatory cytokines level in peripheral blood had positive correlation with the PLI,BI,CI,and the prevalence of periodontitis,but negative correlation with the premature and low birth weight infants. Conclusion There may be some kind of relationship between the periodontal diseases and premature,and low birth weight infants. The effect of periodontal diseases on premature and low birth weight infants may be related to the inflammation-related cytokines in peripheral blood.
Objective To investigate the correlation between periodontal disease and premature and low birth weight infants in pregnant women. Methods One hundred pregnant women were enrolled and divided into control group and experimental group based on whether the new borns were premature or were with low birth weight. The plaque index(PLI),calculus index(CI),gingival bleeding index(BI),probing depth(PD),and clinical attachment loss(CAL)were recorded. And the peripheral blood levels of TNF-α,PGE2,MMP-9,and CRP were detected using enzyme-linked immunoassays. Correlation analysis between the pregnancy,low birth weight infants,periodontal status,and the peripheral blood cytokine in two groups were detected. Results Periodontal status in experimental group were worse than that of pregnant women in control group. The PLI,BI,CI,prevalence of periodontitis,and inflammatory cytokines level in peripheral blood in experimental group were higher than control group(P<0.05).And the PLI,BI,CI,and the prevalence of periodontitis in pregnant women were negatively correlated with premature and low birth weight infants. The inflammatory cytokines level in peripheral blood had positive correlation with the PLI,BI,CI,and the prevalence of periodontitis,but negative correlation with the premature and low birth weight infants. Conclusion There may be some kind of relationship between the periodontal diseases and premature,and low birth weight infants. The effect of periodontal diseases on premature and low birth weight infants may be related to the inflammation-related cytokines in peripheral blood.
引文
[1]曹泽毅.中华妇产科学[M].2版.北京:人民卫生出版社,2005:468-475.
[2]曹采方.临床牙周病学[M].北京:北京大学医学出版社,2006:160-185.
[3]Di Papla R,Marzocco S,Mazzon E,et al.Effect of aminoguanidine in ligature-induced periodontitis in rats[J].J Dent Res,2004,83(4):343-348.
[4]孟焕新.牙周病学[M].3版.北京:人民卫生出版社,2007:141.
[5]Parihar A S,Katoch V,Rajguru S A,et al.Periodontal disease:apossible risk-factor for adverse pregnancy outcome[J].J Int Oral Health,2015,7(7):137-142.
[6]范琳琳,吴倩,徐旭娟,等.孕妇牙周病与早产低出生体重儿关系的Meta分析[J].中国妇幼保健,2013,28(33):5569-5573.
[7]崔巍巍,刘英奇,朱曚曚,等.牙周病与早产低出生体重儿关系的临床研究[J].口腔医学,2012,32(8):477-478,512.
[8]Rakoto-Alson S,Tenenbaum H,Davideau J L.Periodontal diseases,preterm births,and low birth weight:findings from a homogeneous cohort of women in Madagascar[J].J Periodontol,2010,81(2):205-213.
[9]Porat S,Amsalem H,Shah P S,et al.Transabdominal amnioinfusion for preterm premature rupture of membranes:a systematic review and meta analysis of randomized and observational studies[J].AM J Obstet Gynecol,2012,207(5):1-11.
[10]陈旭,冯亮群.妊娠期牙周病与早产低体重儿的关系[J].中国妇幼保健,2013,28(18):3046-3047.
[11]李雁,陈曼诗,曾晓娟,等.转录因子Ets-1和基质金属蛋白酶-9在胎膜早破中表达意义[J].中华实用诊断与治疗杂志,2014,28(7):658-659.
[12]李峰,孙晓菊,谢洪,等.牙周炎患者血清MMP-9、MMP-7以及MCP-1水平与颈动脉斑块不稳定性的相关性研究[J].上海口腔医学,2015,24(5):589-593.
[13]靳瑾,张燕,王志坚,等.胎膜早破伴新生儿感染的高危因素分析及其临床意义[J].南方医科大学学报,2011,31(3):465-468.
[14]田亚光,邱乐宏,陈小滨,等.牙周基础治疗对患牙周炎孕妇C反应蛋白的影响[J].大连医科大学学报,2015,37(2):142-144.
[2]曹采方.临床牙周病学[M].北京:北京大学医学出版社,2006:160-185.
[3]Di Papla R,Marzocco S,Mazzon E,et al.Effect of aminoguanidine in ligature-induced periodontitis in rats[J].J Dent Res,2004,83(4):343-348.
[4]孟焕新.牙周病学[M].3版.北京:人民卫生出版社,2007:141.
[5]Parihar A S,Katoch V,Rajguru S A,et al.Periodontal disease:apossible risk-factor for adverse pregnancy outcome[J].J Int Oral Health,2015,7(7):137-142.
[6]范琳琳,吴倩,徐旭娟,等.孕妇牙周病与早产低出生体重儿关系的Meta分析[J].中国妇幼保健,2013,28(33):5569-5573.
[7]崔巍巍,刘英奇,朱曚曚,等.牙周病与早产低出生体重儿关系的临床研究[J].口腔医学,2012,32(8):477-478,512.
[8]Rakoto-Alson S,Tenenbaum H,Davideau J L.Periodontal diseases,preterm births,and low birth weight:findings from a homogeneous cohort of women in Madagascar[J].J Periodontol,2010,81(2):205-213.
[9]Porat S,Amsalem H,Shah P S,et al.Transabdominal amnioinfusion for preterm premature rupture of membranes:a systematic review and meta analysis of randomized and observational studies[J].AM J Obstet Gynecol,2012,207(5):1-11.
[10]陈旭,冯亮群.妊娠期牙周病与早产低体重儿的关系[J].中国妇幼保健,2013,28(18):3046-3047.
[11]李雁,陈曼诗,曾晓娟,等.转录因子Ets-1和基质金属蛋白酶-9在胎膜早破中表达意义[J].中华实用诊断与治疗杂志,2014,28(7):658-659.
[12]李峰,孙晓菊,谢洪,等.牙周炎患者血清MMP-9、MMP-7以及MCP-1水平与颈动脉斑块不稳定性的相关性研究[J].上海口腔医学,2015,24(5):589-593.
[13]靳瑾,张燕,王志坚,等.胎膜早破伴新生儿感染的高危因素分析及其临床意义[J].南方医科大学学报,2011,31(3):465-468.
[14]田亚光,邱乐宏,陈小滨,等.牙周基础治疗对患牙周炎孕妇C反应蛋白的影响[J].大连医科大学学报,2015,37(2):142-144.