相关粘附分子在牙周炎与冠心病相关性中的作用初探

摘要/Abstract

摘要： 目的：探讨牙周炎与冠心病(coronary heartdisease, CHD)相关性及黏附分子包括血管细胞黏附分子-1（vascular cell adhesion molecule-1；VCAM-1）、细胞间黏附分子-1（intercellular cell adhesion molecule-1，ICAM-1）、P-选择素及E-选择素在两者相关性中的可能作用。方法：选取冠心病伴中重度牙周炎的病人24名 ( PD+CHD组) , 单纯冠心病病人31名 (CHD组) , 中重度牙周炎病人35名 (PD组) 及健康对照组 (HC组) 39名;临床检查并记录，采用酶联免疫吸附反应法（enzyme linked immunosorbent assay，ELISA）常规检测血清样本中ICAM-1、VCAM-1、E-选择素、P-选择素的含量, 进行统计学分析。结果： 1、中、重度慢性牙周炎患者发生冠心病CHD的危险明显高于牙周健康者(OR=2.555，95% CI：1.096～5.958 )；2、各组间血清ICAM-1、VCAM-1、P-选择素、E-选择素水平有统计学差异(P < 0.05)，中、重度牙周炎组和/或CHD组显著高于健康对照组；且排除血压和BMI混杂作用后，各组间黏附分子水平差异仍具统计学意义(P < 0.05)。结论：1、牙周炎尤其是中重度牙周炎是CHD的可能独立危险因素之一。2、中重度慢性牙周炎促进血液中ICAM-1、VCAM-1、P-选择素、E-选择素的表达水平，提示其在牙周炎促进冠心病CHD发生发展的机制中可能发挥了重要作用。

关键词: 牙周炎, 冠心病, 黏附分子, ICAM-1, VCAM-1, P-选择素, E-选择素

Abstract: Objective: To investigate the relationship between moderately or severely chronic periodontitis and CHD, and the possible role of AM (including ICAM-1,VCAM-1,P-selectin and E-selectin) in the association between the two diseases. Methods: The subjects were divided into 4 groups according to the diagnostic angiography and periodontal examination.55 cases that originally diagnosed as coronary heart disease were delected, including 24 cases of coronary artery disease along with periodontitis ( Group PD+CHD)，31 cases of coronary heart disease alone (Group CHD);Group PD was made up of 35 patients suffering moderate to advanced periodontitis.Group HC was 39 healthy volunteers.The general information about periodontal status of all the subjects were recorded and blood samples were withdrawed.The level of HDL-C, LDL-C, TC, Triglyceride (TG), ICAM-1, VCAM-1,E-selectin and P-selectin were detected. Results: 1. The study has shown increased incidence of coronary heart disease（OR=2.555, 95%CI:1.096-5.958) in patients with moderate and sever periodontal disease. 2.The differences of ICAM-1,VCAM-1,P-selectin and E-selectin levels among enrolled groups have statistical significance (P<0.05) by ANOVA. The AM levels in moderate or severe periodontitis patients were higher than healthy controls. Conclusion: 1. Periodontal diseases may be a risk factor of CHD. 2. Moderately or severely periodontal infection can influence the AM levels which may in turn affect the initiation and progression of CHD and may be a risk factor for CHD.

Key words: Periodontitis, Coronary heart disease, Adhesion Molecules, Intercellular Adhesion Molecule-1, Vascular Cell Adhesion Molecule-1, P-selectin, E-selectin

中图分类号:

R781.42

王彩琼林建锋马思环邓辉. 相关粘附分子在牙周炎与冠心病相关性中的作用初探[J]. 口腔医学, 2020, 40(8): 719-722.

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