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目的:对比分析不同糖化血红蛋白(HbA1c)水平2型糖尿病患者的血尿酸、龈沟液炎症因子含量与牙周炎的关系。方法:纳入2型糖尿病合并慢性牙周病患者90例,根据HbA1c水平分为3组(n=30),A组:HbA1c<7.5%;B组:HbA1c在7.5%~9%;C组:HbA1c≥9%。另选血糖、牙周均健康的体检者30例为对照组。对所有受检者均进行血尿酸、龈沟液炎症因子IL-1、TNF-α的检测及牙周状况的检查,并进行统计分析。结果:A、B、C组的血尿酸水平及龈沟液中IL-1、TNF-α含量均高于对照组,随着HbA1c水平的升高,3组患者龈沟液中IL-1、TNF-α含量也逐渐增高,C组>B组>A组(P<0.05);血尿酸水平也有所增加,B、C组高于A组(P<0.05),B组与C组无统计学差异(P>0.05);B、C组PLI、GI、PD以及CAL均高于A组和对照组(P<0.05);A组与对照组差异无统计学意义(P>0.05)。结论:血尿酸及龈沟液中IL-1、TNF-α与2型糖尿病患者牙周炎发生发展密切相关,2型糖尿病患者牙周炎发生率、发生严重程度与HbA1c水平亦相关。当HbA1c≥7.5%时,牙周炎损害的程度均显著增高。
OBJECTIVE: To compare and analyze the relationship between serum levels of uric acid and gingival crevicular fluid inflammatory cytokines and periodontitis in type 2 diabetic patients with different glycated hemoglobin (HbA1c) levels. Methods: Ninety patients with type 2 diabetes mellitus and chronic periodontal disease were divided into three groups (n = 30) according to the level of HbA1c: group A: HbA1c <7.5%; group B: HbA1c between 7.5% and 9%; group C: HbA1c ≧ 9%. Alternative blood glucose, periodontal health examination of 30 patients as a control group. Serum uric acid and gingival crevicular fluid inflammatory cytokines IL-1, TNF-α and periodontal status of all subjects were examined and statistically analyzed. Results: The levels of serum uric acid and the concentrations of IL-1 and TNF-α in GCF were higher than those in the control group. With the increase of HbA1c, the levels of IL-1, (P <0.05). The level of serum uric acid also increased in group C and group B (P <0.05), and there was no statistical significance in group B and C (P> 0.05). The PLI, GI, PD and CAL in group B and C were higher than those in group A and control (P <0.05). There was no significant difference between group A and control (P> 0.05). Conclusion: Serum uric acid and gingival crevicular fluid IL-1 and TNF-α are closely related to the occurrence and development of periodontitis in type 2 diabetic patients. The incidence and severity of periodontitis in type 2 diabetic patients are also related to the level of HbA1c. When HbA1c≥7.5%, the extent of periodontal lesions were significantly increased.