目的观察伴有冠状动脉粥样硬化性心脏病(以下简称冠心病)的牙周炎患者牙周基础治疗后临床指标的变化,并评价其治疗效果。方法32例伴有冠心病的牙周炎患者,在1个月内完成口腔卫生指导、沽治、刮治和根面平整术,治疗后6周复查,进行牙周维护,在治疗前和治疗后3个月时记录全口牙周情况:菌斑指数(plaque index,PLI)、探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、牙龈出血指数(bleeding index,BI),并进行血清超敏C-反应蛋白(high-sensitivity C-reactive,hs-CRP)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(hjgh-density lipoprotein,HDL)、低密度脂蛋白胆固醇(low-density lipoprotein,LDL)及血糖的检测。结果牙周治疗后3个月患者的临床指标显著改善,平均PD由(3.95±0.15)mm减少至(2.93±0.21)mm,平均AL由(3.08±0.43)mm降至(2.43±0.37)mm,PD≥5mm的位点百分比由(22.37±6.88)%降至(3.00±1.80)%,差异均有统计学意义(P〈0.01)。牙周治疗后3个月患者的hs-CRP水平显著降低,由(2.71±2.69)mg/L降至(1.99±2.14)mg/L,差异有统计学意义(P〈0.01);总胆固醇,甘油三酯、HDL、LDL及血糖的测定值与治疗前相比差异均无统计学意义(P〉0.05)。结论在本研究范围内,对于伴有冠心病的牙周炎患者,牙周基础治疗取得良好的治疗效果,患者的牙周临床指标改善,血清hs-CRP水平降低。
Objective To investigate the clinical results of initial periodontal therapy on chronic periodontitis patients with stable coronary heart disease. Methods Thirty-two chronic periodontitis patients with stable coronary heart disease were included in this prospective study. All subjects received oral hygiene instruction, scaling and root planing and clinically monitored for 3 months. The clinical parameters, including plaque index(PLI) , probing depth ( PD ), attachment loss (AL) and bleeding index ( BI ), were recorded at baseline and 3 months after treatment. Serum levels of high-sensitivity C-reactive protein (hs- CRP), cholesterol ( CHO ), triglyceride ( TG ), high-density lipoprotein ( HDL ), low-density lipoprotein (LDL) and glucose (GLU) were also measured. Results At 3 months after initial periodontal therapy, the mean PD of patients reduced from (3.95±0.15) mm to (2.93±0.21) mm (P〈0.01), the mean AL from (3.08±0.43) mm to (2.43±0.37) mm (P 〈0. 01), the percentage of sites with PD≥5 mm from (22.37±6.88) % to (3.00±1.80) % ( P 〈 0. 01). hs-CRP significantly decreased at 3 months after treatment compared with baseline [(2.71±2.69) mg/L vs. (1.99±2.14)mg/L, P 〈0. 05]. CHO,TG, HDL, LDL and GLU decreased slightly( P 〉 0.05). Conclusions Initial periodontal therapy is effective for chronic periodontitis patients with stable coronary heart disease. After initial periodontal therapy, periodontal parameters improved significantly and serum levels of hs-CRP decreased .