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目的通过检测糖尿病伴牙周炎患者全唾液中牙周致病菌的种类和数量,探讨伴该病患者口腔中菌斑微生物的构成及数量特点,分析牙周炎严重程度及血糖控制情况对全唾液中牙周致病菌群的影响。方法采用病例对照研究,纳入糖尿病合并牙周炎患者(DM+CP)24例,单纯牙周炎患者(CP)30例及健康者(NC)30名。收集静息全唾液,采用以16SrRNA为基础的PCR检测全唾液中牙龈卟啉单胞菌(Pg)、中间型普里沃氏菌(Pi)、福塞坦氏菌(Tf)。结果与NC组比较,DM+CP组和CP组3种牙周致病菌检出率及相对含量升高(P<0.05)。DM+CP组Tf检出率(33%)低于CP组(63%)(P<0.05)。与CP组中重度牙周炎患者比较,DM+CP组HbA1c<6.5%及HbA1c≥6.5%患者Tf检出率及相对含量降低(P<0.05)。DM+CP组和CP组中重度牙周炎症患者Pg与Pi检出率及相对含量均高于轻度牙周炎症患者。结论随着系统性糖代谢水平的异常,继而导致全身微环境的改变,最终对牙周局部菌斑微生物的定植产生影响。
Objective To detect the types and quantity of periodontal pathogens in the whole saliva of diabetic patients with periodontal disease and to explore the composition and quantity characteristics of the plaque microbe in the patients with oral cavity disease and to analyze the severity of periodontitis and the control of blood glucose Effect of periodontal pathogenic bacteria in saliva. Methods A case-control study was conducted in 24 patients with diabetes mellitus (DM + CP), 30 patients with simple periodontitis (CP) and 30 healthy individuals (NC). Resting whole saliva was collected and P. salivarius (Pg), intermediate Pf, and Tf were detected in whole saliva using 16S rRNA-based PCR. Results Compared with NC group, the detection rate and relative content of three pathogenic bacteria of periodontal disease in DM + CP group and CP group increased (P <0.05). The detection rate of Tf in DM + CP group (33%) was lower than that in CP group (63%) (P <0.05). Compared with patients with severe periodontitis in CP group, the detection rate and the relative content of Tf in HbA1c <6.5% and HbA1c≥6.5% were decreased in DM + CP group (P <0.05). The detection rate and relative content of Pg and Pi in patients with severe periodontal inflammation in DM + CP group and CP group were higher than those in mild periodontitis patients. Conclusion With the abnormal level of systemic glycometabolism, which in turn leads to the change of systemic microenvironment, eventually affecting the local plaque microbiota colonization.