牙周基础治疗对慢性肾病伴牙周炎患者炎症因子影响的Meta分析

doi:10.7518/hxkq.2020.06.012

华西口腔医学杂志 ›› 2020, Vol. 38 ›› Issue (6): 672-680.doi: 10.7518/hxkq.2020.06.012

牙周基础治疗对慢性肾病伴牙周炎患者炎症因子影响的Meta分析

赖静¹^,²(), 白远亮¹^,², 柏银¹^,², 梅杰¹^,², 张芷玮¹^,³, 唐雯静²^,³, 黄姣¹^,²()

1.重庆医科大学附属口腔医院牙周科,重庆 400015
2.口腔疾病与生物医学重庆市重点实验室,重庆 400015
3.重庆医科大学重庆市高校市级口腔生物医学工程重点实验室,重庆 400015

收稿日期:2020-01-08 修回日期:2020-05-23 出版日期:2020-12-01 发布日期:2020-12-07
通讯作者: 黄姣 E-mail:2017140057@stu.cqmu.edu.cn;huangjiao@hospital.cqmu.edu.cn
作者简介:赖静,主治医师,硕士,E-mail：2017140057@stu.cqmu.edu.cn
基金资助:
重庆市卫计委重点资助课题(2015ZDXM018);重庆高校创新团队建设计划资助课题(CXTDG201602006)

A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis

Lai Jing¹^,²(), Bai Yuanliang¹^,², Bai Yin¹^,², Mei Jie¹^,², Zhang Zhiwei¹^,³, Tang Wenjing²^,³, Huang Jiao¹^,²()

1. Dept. of Periodontics, Affiliated Stomatology Hospital, Chongqing Medical University, Chongqing 400015, China
2. Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing 400015, China
3. Chongqing Medical University, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 400015, China

Received:2020-01-08 Revised:2020-05-23 Online:2020-12-01 Published:2020-12-07
Contact: Huang Jiao E-mail:2017140057@stu.cqmu.edu.cn;huangjiao@hospital.cqmu.edu.cn
Supported by:
Key Funding Projects of Chongqing Municipal Health Planning Commission(2015ZDXM018);Project of Innovation Team Construction in Chongqing University(CXTDG201602006)

摘要/Abstract

摘要：

目的系统评价牙周基础治疗对慢性肾病伴牙周炎患者炎症因子的影响。方法计算机检索中国学术期刊全文数据库（CNKI）、万方数据库、中国生物医学文献数据库（CBM）、PubMed、EMbase以及Cochrane Library等数据库,检索时限为从建库截止到2019年12月。由2名研究者收集所有关于牙周基础治疗（牙周非手术治疗）对于慢性肾病伴牙周炎患者炎症因子[C反应蛋白（CRP）、白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α]影响的文献,并且根据纳入排除标准对文献进行筛选,对研究的质量进行严格评价和资料提取,用Revman 5.3软件对符合标准的随机对照试验进行Meta分析。结果最终纳入了6项研究分析,Meta分析结果显示,与对照组相比,牙周基础治疗能显著降低慢性肾病伴牙周炎患者CRP水平[MD=-0.58,95%CI（-1.13,-0.02）,P=0.04]和IL-6水平[MD=-2.76,95%CI（-5.15,-0.37）,P=0.02],但TNF-α水平[MD=-3.87,95%CI（-8.79,1.05）,P=0.12]没有得到明显改善。结论慢性肾病伴牙周炎的患者在规律治疗肾病的同时行牙周基础治疗,不仅能够缓解其牙周炎症状况,还可在一定程度上改善全身的部分炎症因子的状态,有利于慢性肾病和牙周炎的控制和治疗。

关键词: 慢性肾病, 牙周炎, 牙周基础治疗, C反应蛋白, 白细胞介素-6, 肿瘤坏死因子-α

Abstract:

Objective A study was conducted to systematically evaluate the clinical efficacy of inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. Methods We searched the databases of CNKI, Wanfang, CBM, PubMed, Embase, and Cochrane Library from inception to December 2019. Two reviewers independently collected all literature related to inflammatory factors in patients with chronic kidney disease and periodontitis after non-surgical periodontal therapy. These factors include C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). The literature was screened according to the inclusion and exclusion criteria. The quality of the studies was strictly evaluated, and the data were extracted. The literature of randomized controlled trials in accordance with the standards was Meta-analyzed with Revman 5.3 software. Results Six randomized controlled trials were included. Compared with the control groups, the results of meta-analysis showed that non-surgical periodontal therapy significantly reduced the levels of CRP [MD=-0.58, 95%CI (-1.13, -0.02), P=0.04] and IL-6 [MD=-2.76, 95%CI (-5.15, -0.37), P=0.02] in these patients but not that of TNF-α [MD=-3.87, 95%CI (-8.79, 1.05), P=0.12]. Conclusion Simultaneous regular renal treatment and non-surgical periodontal therapy can help relieve the periodontal damage on patients with chronic kidney disease and periodontitis. Moreover, it can improve the status of some inflammatory factors. This finding is conducive to the control and treatment of chronic kidney disease and periodontitis and needs to be a focus of research and in clinical operation.

Key words: chronic kidney disease, periodontitis, periodontal therapy, C-reactive protein, interleukin-6, tumor necrosis factor-α

中图分类号:

R781.4

赖静, 白远亮, 柏银, 梅杰, 张芷玮, 唐雯静, 黄姣. 牙周基础治疗对慢性肾病伴牙周炎患者炎症因子影响的Meta分析[J]. 华西口腔医学杂志, 2020, 38(6): 672-680.

Lai Jing, Bai Yuanliang, Bai Yin, Mei Jie, Zhang Zhiwei, Tang Wenjing, Huang Jiao. A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis[J]. West China Journal of Stomatology, 2020, 38(6): 672-680.

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纳入研究	年份	年龄/岁	样本量	性别	时间点	治疗方式	测量指标
纳入研究	年份	年龄/岁	（T/C）	（男/女）	时间点	治疗方式	测量指标
Wehmeyer等^[24]	2013	53.4±9.8	23/23	33/18	3个月、6个月	腹膜透析	IL-6、白蛋白
Fang等^[25]	2015	54.62±6.32	48/49	42/55	6周、3个月、6个月	血液透析	TNF-α、IL-6、CRP、铁蛋白等
Guo等^[26]	2017	57.5±8.5	26/27	24/29	6周	常规肾病治疗	TNF-α、IL-6、CRP
张晋玮等^[27]	2017	48.61±4.60	31/30	30/31	1个月	腹膜透析	CRP
李浩萍等^[28]	2018	40.28±6.30	36/36	39/33	8周	血液透析	TNF-α、IL-6、CRP、血清肌酐、24 h尿蛋白
马欣等^[29]	2018	39.2±5.2	52/46	56/42	6周	血液透析	TNF-α、IL-6、CRP、血清肌酐、24 h尿蛋白

牙周基础治疗对慢性肾病伴牙周炎患者炎症因子影响的Meta分析

A Meta-analysis of the effect of non-surgical periodontal therapy on inflammatory factors in patients with chronic kidney disease and periodontitis

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