华西口腔医学杂志

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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

袁堂霞1 张彦表1 周云2 王凡涛1 王峰3   

  1. 1.潍坊医学院口腔医学院口腔修复教研室, 潍坊261053; 2.临沂市中医医院口腔科, 临沂276000;3.潍坊医学院附属医院内分泌科, 潍坊261031
  • 出版日期:2013-08-01 发布日期:2013-08-01
  • 通讯作者: 张彦表,Tel:13256362257
  • 作者简介:袁堂霞(1973—),女,山东人,讲师,硕士
  • 基金资助:

    潍坊市科学技术发展计划基金资助项目(20121239)

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

Yuan Tangxia1, Zhang Yanbiao1,Zhou Yun2, Wang Fantao1, Wang Feng3.   

  1. 1. Dept. of Prosthodontics, School of Stomatology, Weifang Medical College, Weifang 261053, China; 2. Dept. of Stomatology, Chinese Medicine Hospital in Linyi City, Linyi 276000, China; 3. Dept. of Endocrinology, The Affiliated Hospital of Weifang Medical College, Weifang 261031, China
  • Online:2013-08-01 Published:2013-08-01

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。

关键词: 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

Abstract:

 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.

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