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论文摘要

牙周非手术治疗对2型糖尿病伴牙周炎患者糖化血红蛋白A1c和血清可溶性细胞间黏附分子-1的影响

Effect of non-surgical periodontal therapy on level of serum soluble intercellular adhesion molecule-1 and glycated hemoglobin A1c in patients with type 2 diabetes and chronic periodontitis

作者:袁堂霞 张彦表 周云 王凡涛 王峰

Author:Yuan Tangxia, Zhang Yanbiao,Zhou Yun, Wang Fantao, Wang Feng.

收稿日期:          年卷(期)页码:2013,31(4):415-415-419,424

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:慢性牙周炎,2型糖尿病,牙周非手术治疗,糖化血红蛋白A1c,可溶性细胞间黏附分子-1,

Key words:chronic periodontitis,type 2 diabetes mellitus,non-surgical periodontal therapy,glycated hemoglobin A1c,soluble intercellular adhesion molecule-1,

基金项目:

潍坊市科学技术发展计划基金资助项目(20121239)

中文摘要

目的 探讨牙周非手术治疗对2型糖尿病伴慢性牙周炎(DMCP)患者牙周状况、糖代谢及血清可溶性细胞间黏附分子-1(sICAM-1)的影响。方法 选择诊断为2型糖尿病伴慢性牙周炎的患者,按糖化血红蛋白A1c ( GHbA1c )控制水平分为血糖控制良好组(GHbA1c<7.00%,DMCP1组,30例)和血糖控制较差组(GHbA1c≥7.00%,DMCP2组,30例);选择不伴有系统性疾病的慢性牙周炎患者(CP组,30例)为对照组。所有患者均进行牙周非手术治疗,分析治疗前(基线)及治疗后1、3个月时探诊深度(PD)、临床附着丧失(CAL)、菌斑指数(PLI)、龈沟出血指数(SBI)、探诊出血(BOP)、空腹血糖(FPG)、GHbA1c及血清sICAM-1水平的变化。结果 治疗后1、3个月时,3组PD、SBI、PLI、BOP阳性率、血清sICAM-1水平比基线时均明显降低(P<0.05),CP组和DMCP1组CAL比基线时亦均明显降低(P<0.05),但DMCP2组CAL无明显变化(P>0.05)。治疗后3个月时,DMCP2组GHbA1c水平与基线时比较平均降低1.12%,差异有统计学意义(P<0.05),但CP组和DMCP1组在整个观察期间GHbA1c水平与基线时比较差异均无统计学意义(P>0.05)。结论 牙周非手术治疗可降低2型糖尿病伴牙周炎患者的牙周炎症程度及血清sICAM-1的水平,并可改善血糖控制良好者的牙周附着水平;该治疗还可以降低血糖控制较差者的GHbA1c水平。

英文摘要

Objective To evaluate the effects of non-surgical periodontal treatment on clinical periodontal measurements, glycemic control, and level of serum soluble intercellular adhesion molecule-1(sICAM-1) in type 2 diabetes mellitus with chronic periodontitis patients.Methods Patients with type 2 diabetes and chronic periodontitis were selected and classified into well-controlled group[glycated hemoglobin A1c ( GHbA1c ) <7.00%, n=30, DMCP1 group] and poorly-controlled group(GHbA1c≥7.00%, n=30, DMCP2 group). Thirty systemically healthy patients with chronic periodontitis were recruited as control group(CP group). All subjects underwent non-surgical periodontal therapy. Plaque index(PLI), sulcus bleeding index(SBI), bleeding on probing(BOP), probing depth(PD), clinical attachment loss (CAL), serum sICAM-1 concentration, and the value of fasting plasma glucose(FPG), GHbA1c were recorded at baseline, 1 and 3 months after periodontal treatment.Results The three study groups showed significant improvements for the levels of PD, SBI, PLI, BOP, and serum sICAM-1 concentration at 1 and 3 months after non-surgical periodontal treatment(P<0.05). The level of CP group and DMCP1 group also showed significant improvements for the levels of CAL(P<0.05), but no significant change was found in DMCP2 group(P>0.05). At 3 months after periodontal treatment, GHbA1c levels in DMCP2 group significantly decreased by 1.12%(P<0.05), whereas no significant changes were found in CP and DMCP1 groups(P>0.05).Conclusion Non-surgical periodontal treatment can significantly improve periodontal health status in patients with type 2 diabetes and periodontitis, reduce the level of serum sICAM-1, and can reduce the level of GHbA1c in poorly controlled type 2 diabetic patients.

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