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目的 研究口腔感染与冠心病的关系。方法 比较 5 9例冠心病患者和 5 1例非冠心病患者的冠心病常见易患因素、口腔健康状况以及唾液血链球菌的可培养菌总数SSs和龈下菌斑血链球菌的可培养菌总数SSp。因SSs和SSp呈明显偏态分布 ,采用其自然对数转换值 [LN(SSs +1)、LN(SSp +1) ]进行比较。采用logistic多元逐步回归向前法分析并筛选出冠心病的危险因素。结果 单因素分析发现冠心病组患者总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C)、牙龈炎牙数、牙周炎牙数、LN(SSp +1)均高于非冠心病组 (P <0 0 5～ 0 0 1) ;多因素分析发现仅LN(SSp +1)和LDL C与冠心病显著相关 ,前者的相对危险度为 1 438( 95 %可信区间 1 12 7～ 1 834) ,后者的相对危险度为 2 2 71( 95 %可信区间 1 2 49～ 4 12 9)。结论 口腔健康状况与冠心病密切相关 ,尤其是龈下菌斑中血链球菌菌量与冠心病独立相关。心血管医生有义务提醒患者积极去除口腔内可能存在的危险因素。
Objective To study the relationship between oral infection and coronary heart disease. Methods To compare the common predisposition factors of coronary heart disease in 59 patients with coronary heart disease and 51 patients with non-coronary heart disease, the oral health status and the total number of culturable bacteria SSs of Streptococcus salivarius and the culturable bacteria of Streptococcus sanguis The total number of SSp. Due to the obvious skewed distribution of SSs and SSp, their natural logarithmic transformation values [LN (SSs +1) and LN (SSp +1)] were compared. Logistic multivariate stepwise regression was used to analyze and screen the risk factors of coronary heart disease. Results Univariate analysis showed that total cholesterol (TC), low density lipoprotein cholesterol (LDL C), gingivitis teeth, periodontitis teeth number and LN (SSp +1) in CHD group were significantly higher than those in non-CHD group (P < Multivariate analysis showed that LN (SSp +1) and LDL C were significantly associated with coronary heart disease, with a relative risk of 1 438 (95% confidence interval 1 12 7 to 1 834) , The relative risk of the latter is 2 2 71 (95% confidence interval 1 2 49 ~ 4 12 9). Conclusion Oral health is closely related to coronary heart disease, especially the amount of S. sanguis in subgingival plaque is independent of coronary heart disease. Cardiovascular doctors have an obligation to remind patients to actively remove possible risk factors in the oral cavity.