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目的探讨细菌外排泵抑制剂(microbial efflux pump Inhibitor,EPI)——维拉帕米对以血卟啉单甲醚(hematoporphyrin monom-ethylether,HMME)为光敏剂的光动力疗法(photodynamic therapy,PDT)抵抗牙菌斑生物膜内主要致龋菌作用的影响。方法以变形链球菌、血链球菌、嗜酸性乳杆菌和粘性放线菌为实验菌株,建立牙菌斑生物膜模型。以维拉帕米作为细菌外排泵抑制剂,根据在PDT过程中加入维拉帕米和光敏剂的先后顺序,实验分为5组:A组:同时加入光敏剂和维拉帕米PDT处理组,B组:先加入维拉帕米后加入光敏剂PDT处理组,C组:先加入光敏剂后加入维拉帕米PDT处理组,D组:单纯PDT处理组,E组:生理盐水处理组。激光照射后平板菌落计数观察PDT作用后牙菌斑内致龋菌的活力。结果与生理盐水处理组相比,单纯PDT处理组牙菌斑内致龋菌存活的数量(CFU/mL)明显减少(P<0.05),其抑菌率高达95.26%,与单纯PDT处理组相比,加入维拉帕米的PDT处理组内牙菌斑内致龋菌存活数量有上升趋势。其中先加入维拉帕米后加入光敏剂PDT处理组牙菌斑内致龋菌存活数量显著性上升(P<0.05),抑菌率仅为80.92%。结论 HMME-PDT可以通过有效抑制致龋菌的生长而起到防龋的作用。细菌外排泵抑制剂对HMME-PDT抑制牙菌斑生物膜内主要致龋菌有抑制作用。
Objective To investigate the effect of verapamil on photodynamic therapy (PDT) of patients with microbial efflux pump inhibitor (EPI) and hematoporphyrin monom-ethylether (HMME) ) To resist the effects of the major cariogenic bacteria in plaque biofilms. Methods Streptococcus mutans, Streptococcus sanguis, Lactobacillus acidophilus and Actinomyces viscosus were used as experimental strains to establish the model of dental plaque biofilm. Verapamil was used as a bacterial efflux pump inhibitor. According to the order of adding verapamil and photosensitizer during PDT, the experiment was divided into five groups: group A: PDT with photosensitizer and verapamil Group B: adding verapamil followed by photosensitizer PDT; group C: adding photosensitizer and then verapamil PDT; group D: PDT alone; group E: saline group. The plate colonies were counted after laser irradiation to observe the viability of cariogenic bacteria in dental plaque after PDT. Results Compared with the saline group, the viability of cariogenic bacteria in the PDT group was significantly decreased (P <0.05), and the antibacterial rate was 95.26%. Compared with the PDT group The viability of cariogenic bacteria in the plaque in PDT treatment group added with verapamil had an increasing trend. Among them, the number of cariogenic bacteria in PDT treatment group after adding verapamil was significantly increased (P <0.05), and the antibacterial rate was only 80.92%. Conclusion HMME-PDT can prevent caries by effectively inhibiting the growth of cariogenic bacteria. Inhibition of bacterial efflux pump on HMME-PDT inhibition of plaque in the main bacterial cariogenic bacteria inhibitory effect.