牙周非手术治疗对重度慢性牙周炎患者龈沟液中C反应蛋白的影响

›› 2016, Vol. 36 ›› Issue (10): 876-879.

牙周非手术治疗对重度慢性牙周炎患者龈沟液中C反应蛋白的影响

邱大鹏,张倩,陈斌,闫福华

南京大学医学院附属口腔医院，南京市口腔医院

收稿日期:2016-02-22 修回日期:2016-06-12 出版日期:2016-10-28 发布日期:2016-10-25
通讯作者: 闫福华 E-mail:yanfh@nju.edu.cn
基金资助:
江苏省临床医学科技专项;江苏省双创计划引进人才;江苏特聘医学专家资助项目

Effect of nonsurgical periodontal therapy on gingival crevicular fluid levels of C-reactive protein in severe chronic periodontitis

Received:2016-02-22 Revised:2016-06-12 Online:2016-10-28 Published:2016-10-25

摘要/Abstract

摘要： ［摘要］　目的　检测牙周基础治疗对慢性牙周炎患者龈沟液中C反应蛋白（CRP）的影响，为牙周病活动期诊断及判断牙周治疗的效果提供一定的客观依据。方法　用滤纸条收集30例重度慢性牙周炎患者的60个重度牙周炎牙位（探诊深度PD≥6mm）和60个轻度牙周炎牙位（PD≤4mm）患牙治疗前及治疗后1、3、6、12月的龈沟液并称重，用酶联免疫吸附测定法（ELISA）测定CRP的含量并记录牙周临床指标，15例牙周健康者的30个健康牙位作为对照。结果　深牙周袋牙位的CRP在龈沟液中的浓度(968.06±360.54pg/ml)显著高于浅牙周袋牙位(291.65±65.62pg/ml)，且疾病牙位的CRP浓度均显著高于健康牙位(33.47±24.53pg/ml)，龈沟液中CRP浓度与探诊深度(r=0.825,P<0.05)、附着丧失(r=0.833,P<0.05)、菌斑指数(r=0.741,P<0.05)呈正相关关系。同时，牙周基础治疗后沟液中CRP浓度明显降低，并且与口腔卫生情况有关。结论　龈沟液中CRP浓度与牙周破坏程度有关，非手术治疗后龈沟液中CRP浓度下降。

关键词: 重度牙周炎, 龈沟液, C反应蛋白

Abstract: Abstract：　Objective　To evaluate the effect of nonsurgical periodontal therapy on gingival crevicular fluid (GCF) of C-reactive protein (CRP) levels in different tooth-site of subjects with severe chronic periodontitis, to help to diagnose the type of the activity of periodontitis and to assess the outcome of periodontal therapy. Methods　 GCF samples were collected by filter paper strip and weighed by tooth-site from 60 severe periodontitis ( probing depth≥6mm) sites and 60 mild periodontitis ( probing depth≤4mm) sites of 30 severe chronic periodontitis patients at baseline and at 1, 3, 6, 12 months after nonsurgical therapy. 30 healthy sites of 15 subjects with healthy periodontium were obtained as a control. The periodontal clinical parameters were recorded and the C-reactive protein levels in GCF were assessed by enzyme-linked immunosorbent assay (ELISA). Results　The levels of CRP in GCF in deep pocket sites were (968.06±360.54pg/ml)significantly higher than shallow pocket sites(291.65±65.62pg/ml), and the levels of CRP in GCF of all diseased sites were higher than healthy subjects(33.47±24.53pg/ml). Positive correlations existed between CRP concentration and probing depth(0.825,P<0.05),clinical attachment loss(0.833,P<0.05),plaque index(0.741,P<0.05). Moreover, the concentration of CRP in disease sites showed a statistically decrease after nonsurgical therapy and were related to the condition of oral hygiene. Conclusions　 The concentration of CRP in GCF may correlate with the degree of periodontal tissue destruction, the levels of CRP reduced after nonsurgical therapy in diseased sites.

Key words: 　severe chronic periodontitis, gingival crevicular fluid, C-reactive protein

邱大鹏张倩陈斌闫福华. 牙周非手术治疗对重度慢性牙周炎患者龈沟液中C反应蛋白的影响[J]. , 2016, 36(10): 876-879.

参考文献

[1]AlRowis R,AlMoharib HS,AlMubarak A,et al.Oral fluid-based biomarkers in periodontal disease - part 2Gingival crevicular fluid[J].. J Int Oral Health,2014,6(5):126-35
[2]Kanaparthy R,Kanaparthy A,Mahendra M.C-reactive protein as a marker of periodontal disease[J].Gen Dent,2012,60(1):e1-5
[3]Armitage GC.Development of a classification system for periodontal diseases and conditions[J].Ann Periodontol,1999,4(1):1-6
[4]Burt B.Research,Science and Therapy Committee of the American Academy of Periodontology[J].J Periodontol,2005,76(8):1406-1419
[5]Buduneli N,Kinane DF.Host-derived diagnostic markers related to soft tSuppl 11 destruction and bone degradation in periodontitis[J].J Clin Periodontol,2011,38(Suppl 11):85-105
[6]Pejcic A,Kesic LJ,Milasin J.C-reactive protein as a systemic marker of inflammation in periodontitis[J].Eur J Clin Microbiol Infect Dis,2011,30(3):407-414
[7]Megson E,Fitzsimmons T,Dharmapatni K,et al.C-reactive protein in gingival crevicular fluid may be indicative of systemic inflammation[J].J Clin Periodontol,2010,37(9):797-804
[8]Kumar S,Shah S,Budhiraja S,et al.The effect of periodontal treatment on C-reactive protein: A clinical study[J].J Nat Sci Biol Med,2013,4(2):379-382
[9]Slade GD,Offenbacher S,Beck JD,et al.Acute-phase inflammatory response to periodontal disease in the US population[J].J Dent Res,2000,79:49-57
[10] Shojaee M,Fereydooni Golpasha M,Maliji G,et al.C - reactive protein levels in patients with periodontal disease and normal subjects[J]
[11]Mohan M,Jhingran R,Bains VK,et al.Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus[J].J Periodontal Implant Sci,2014,44(4):158-168
[12]Oh H,Hirano J,Takai H,et al.Effects of initial periodontal therapy on interleukin-1β level in gingival crevicular fluid and clinical periodontal parameters[J].J Oral Sci,2015,57(2):67-71
[13]宗敏，杨丕山.基础治疗对侵袭性牙周炎患者龈沟液骨钙素水平的影响[J].口腔医学,2012,32(9):548-549
[14]Makino-Oi A,Ishii Y,Hoshino T,et al.Effect of periodontal surgery on oral health-related quality of life in patients who have completed initial periodontal therapy[J].J Periodontal Res,2015,6:1-9
[15]Becerik S,?ztürk V?,Atmaca H,et al.Gingival crevicular fluid and plasma acute-phase cytokine levels in different periodontal diseases[J].J Periodontol,2012,83(10):1304-13
[16]Kunjappu JJ,Mathew VB,Hegde S,et al.Assessment of the alkaline phosphatase level in gingival crevicular fluid,as a biomarker to evaluate the effect of scaling and root planing on chronic periodontitis: An in vivo study[J].J Oral Maxillofac Pathol,2012,16(1):54-57
[17]Oliveira APL,Faveri M,Gursky LC,et al.Effects of periodontal therapy on GCF cytokines in generalized aggressive periodontitis subjects[J].J Clin Periodontol,2012,39(3):295-302
[18]Fiorini T,Susin C,da Rocha JM,et al.Effect of nonsurgical periodontal therapy on serum and gingival crevicular fluid cytokine levels during pregnancy and postpartum[J].J Periodontal Res,2013,48(1):126-133