黏蛋白-4和基质金属蛋白酶-7在种植体周病中的表达及意义

doi:10.7518/hxkq.2022.01.007

华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (1): 45-51.doi: 10.7518/hxkq.2022.01.007

黏蛋白-4和基质金属蛋白酶-7在种植体周病中的表达及意义

姜丹丹¹(), 周政¹(), 沈玉凤¹, 唐小雪¹, 缑小蕊¹, 黄枚钰¹, 童一洲², 陈苗苗¹, 余重庆¹

^1.石河子大学医学院第一附属医院口腔科，石河子 832000
^2.石河子大学口腔医学系，石河子 832000

收稿日期:2021-02-01 修回日期:2021-11-08 出版日期:2022-02-01 发布日期:2022-02-07
通讯作者: 周政 E-mail:hspiritjiang@163.com;15909935188@163.com
作者简介:姜丹丹，医师，硕士，E-mail：hspiritjiang@163.com
基金资助:
石河子大学科技计划项目(ZZZ201957A)

Expression and significance of mucin-4 and matrix metalloproteinase-7 in peri-implant disease

Jiang Dandan¹(), Zhou Zheng¹(), Shen Yufeng¹, Tang Xiaoxue¹, Gou Xiaorui¹, Huang Meiyu¹, Tong Yizhou², Chen Miaomiao¹, Yu Chong-qing¹

^1.Dept. of Stomatology, the First Affiliated Hospital, Medical College, Shihezi University, Shihezi 832000, China
^2.Dept. of Stomatology, Shihezi University, Shihezi 832000, China

Received:2021-02-01 Revised:2021-11-08 Online:2022-02-01 Published:2022-02-07
Contact: Zhou Zheng E-mail:hspiritjiang@163.com;15909935188@163.com
Supported by:
Science and Technology Plan of Shihezi University(ZZZ201957A);Correspondence: Zhou Zheng, E-mail: 15909935188@163.com

摘要/Abstract

摘要： 目的

探讨基质金属蛋白酶（MMP）-7、MMP-8和黏蛋白（MUC）-4在种植体周围龈沟液（PICF）中的水平，分析二者是否具有区分种植体周围疾病与健康个体的能力，以期为寻找辅助种植体周围疾病诊断、评估和治疗的新型参考指标提供理论基础。

方法

按照纳入和排除标准选择上部修复体负载2~5年的63位受试者，其中对照组24例，种植体周围炎（PI）组39例。收集受试者一般情况及种植体周围临床指标，X线片测量牙槽骨吸收量，酶联免疫吸附试验法（ELISA）检测PICF中的MUC-4、MMP-7、MMP-8水平。

结果

PI组和对照组受试者的年龄、性别等参数信息差异无统计学意义，PI组MMP-7（P<0.05）、MMP-8（P<0.001）的表达水平均高于对照组，PI组MUC-4表达水平低于对照组（P<0.001）；相关性分析显示，MMP-7与牙周探诊深度（PPD）呈正相关（r=0.451，P<0.001）；MMP-8分别与PPD、探诊出血（BOP）、牙龈指数（GI）呈正相关（r=0.619，P<0.001； r=0.478，P<0.001； r=0.332，P=0.009）； MUC-4分别与PPD、BOP、GI呈负相关（r=-0.492，P<0.001； r=-0.321，P=0.010； r=-0.396，P=0.001）。MMP-7、MMP-8、MUC-4对PI均具有一定的诊断效能，其中MMP-8对PI的诊断效能最好，当MMP-8>21.21时，其曲线下面积为0.868，诊断PI的灵敏度为0.96、特异度为0.68；MMP-7、MUC-4并联诊断模型的诊断效能高于两种因子单独诊断，模型对PI的诊断灵敏度为0.96，特异度为0.56。

结论

MMP-7、MUC-4的水平在PI组与对照组之间差异有统计学意义，可能成为预测是否罹患PI的诊断指标；联合MMP-7、MUC-4对炎症具有较好的诊断价值。

关键词: 种植体周围疾病, 黏蛋白-4, 基质金属蛋白酶-7

Abstract: Objective

This study aims to detect the levels of mucin (MUC)-4, metalloproteinase (MMP)-7, and MMP-8 in peri-implant crevicular fluid (PICF) and investigate whether the novel combinations of MMP-7 and MUC-4 are effective markers of peri-implant diseases, particularly when used in the PICF of healthy individuals, to provide a theoretical basis for finding a novel reference index that can aid the diagnosis, evaluation, and treatment of peri-implant diseases.

Methods

A total of 63 subjects with 2-5 years of upper prosthesis loading were selected according to inclusion and exclusion criteria, composed of 24 controls and 39 patients with peri-implantitis (PI) group. MUC-4, MMP-7, and MMP-8 levels were detected through enzyme linked immunosorbent assay (ELISA).

Results

No significant differences in age, sex, and other parameters were found between the PI and control groups. The PI group had higher MMP-7 and MMP-8 expression levels (P<0.05) but lower MUC-4 level (P<0.001). Correlation analysis showed that MMP-7 was positively correlated with pocket probing depth (PPD) (r=0.451, P<0.001); MMP-8 was positively correlated with PPD, bleeding on probing (BOP), and gingival index (GI) (r=0.619, P<0.001; r=0.478, P<0.001; r=0.332, P=0.009). MUC-4 was negatively correlated with PPD, BOP, and GI (r=-0.492, P<0.001; r=-0.321, P=0.010; r=-0.396, P=0.001). MMP-7, MMP-8, and MUC-4 had certain diagnostic efficacy for PI. MMP-8 exhibited the best diagnostic efficacy for PI. When the cutoff value of MMP-8 was >21.21, the area under the curve (AUC) was 0.868, and the sensitivity and specificity for the diagnosis of PI were 0.96 and 0.68, respectively. The diagnostic efficacy of MMP-7 and MUC-4 parallel diagnostic models was higher than that of each factor, and the diagnostic sensitivity of the model for PI was 0.96, and the specificity was 0.56.

Conclusion

Differences in MMP-7 and MUC-4 levels were found between the inflammation and control groups and may be diagnostic indicators for predicting PI; combinations of MMP-7 and MUC-4 had a good diagnostic value for inflammation.

Key words: peri-implant disease, mucin-4, matrix metalloproteinase-7

中图分类号:

Q 26

姜丹丹, 周政, 沈玉凤, 唐小雪, 缑小蕊, 黄枚钰, 童一洲, 陈苗苗, 余重庆. 黏蛋白-4和基质金属蛋白酶-7在种植体周病中的表达及意义[J]. 华西口腔医学杂志, 2022, 40(1): 45-51.

Jiang Dandan, Zhou Zheng, Shen Yufeng, Tang Xiaoxue, Gou Xiaorui, Huang Meiyu, Tong Yizhou, Chen Miaomiao, Yu Chong-qing. Expression and significance of mucin-4 and matrix metalloproteinase-7 in peri-implant disease[J]. West China Journal of Stomatology, 2022, 40(1): 45-51.

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变量		对照组	PI组	χ²/Z/t值	P值
性别	男	22/56.4%	13/54.2%	0.666	0.414
性别	女	17/43.6%	11/45.8%	0.666	0.414
年龄/岁		50.72±11.94	49.08±12.41	0.520	0.605
PPD/mm		1.97±0.69	3.09±0.87	-5.706	<0.001
BOP	0	21/53.8%	7/29.2%	-3.097	0.002
	1	14/35.9%	5/20.8%
	2	4/10.3%	4/16.7%
	3	0/0.0	2/8.3%
	4	0/0.0	6/25.0%
GI	0	34/87.2%	10/41.7%	-3.9	<0.001
	1	2/5.1%	3/12.5%
	2	3/7.7%	9/37.5%
	3	0/0.0	0/0.0
	4	0/0.0	2/8.3%
mPLI	0	32/82.1%	17/70.8%	-1.064	0.287
	1	5/12.8%	5/20.8%
	2	2/5.1%	0/0.0
	3	0/0.0	0/0.0
	4	0/0.0	2/8.3%

变量		PPD	BOP	GI	mPLI
MMP-7	r值	0.451*	0.163	0.180	0.101
	P值	<0.001	0.201	0.158	0.431
MMP-8	r值	0.619*	0.478*	0.332*	0.216
	P值	<0.001	<0.001	0.009	0.095
MUC-4	r值	-0.492*	-0.321*	-0.396*	0.064
	P值	<0.001	0.010	0.001	0.618

黏蛋白-4和基质金属蛋白酶-7在种植体周病中的表达及意义

Expression and significance of mucin-4 and matrix metalloproteinase-7 in peri-implant disease

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变量	AUC	P值	灵敏度	特异度	约登指数	截断值
MMP-7	0.668	0.025	0.46	0.92	0.38	>21.56
MMP-8	0.868	<0.001	0.96	0.68	0.63	>21.21
MUC-4	0.772	<0.000 1	0.91	0.56	0.48	≤4.58
并联诊断		<0.001	0.96	0.56