目的研究汉族人群中、重度牙周炎与冠心病的相关性并初步探讨C反应蛋白在二者相关性中的可能作用。方法检测和分析40名健康者(健康组)、40例中、重度牙周炎患者(牙周炎组)、28例冠状动脉粥样硬化性心脏病(简称冠心病)患者(冠心病组)及47例同时患冠心病及中、重度牙周炎的患者(冠心病+牙周炎组)血清C反应蛋白水平、血脂水平(血清低密度脂蛋白、高密度脂蛋白胆固醇、总胆固醇和甘油三酯)和牙周临床指数(附着丧失、探诊深度和探诊出血)。结果单因素方差分析结果显示,健康组、牙周炎组、冠心病组及牙周炎+冠心病组的血清C反应蛋白水平分别为(1.30±0.15)、(2.44±0.18)、(5.99±0.82)和(6.88±0.71)mg/L,各组血清C反应蛋白水平问的差异具有统计学意义(P〈0.001),且经协方差分析校正年龄、受教育状况、血压和体重指数后显示,各组血清C反应蛋白水平间的差异仍具有统计学意义(P〈0.001)。多元Logistic回归分析结果显示,中、重度牙周炎患者发生冠心病的可能性高于牙周健康者,其发生冠心病的相对风险率比值比为2.417(P=0.039;95%CI:1.126~6.659)。经协方差分析校正年龄、受教育状况、血压和体重指数后,各组血清总胆固醇水平间差异仍具有统计学意义(P=0.017)。结论严重的牙周感染可能通过改变血清C反应蛋白水平继而影响全身炎症反应和冠心病的发生及发展,可能是冠心病事件的危险因素之一。
Objective To investigate the correlation between moderate to severe periodontitis and coronary heart disease (CHD) and to examine the serum C-reactive protein (CRP) levels in subjects with CHD and/or moderate to severe periodontitis. Methods Serum CRP levels, serum lipids [ low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), total cholesterol (TC) and triglyceride(TG) ] and clinical periodontal parameters [ clinical attachment loss (CAL), probing depth (PD), and bleeding on probing (BOP)] were measured and analyzed in coexistant moderate to severe periodontitis and CHD patients ( n = 47 ), CHD patients ( n = 28 ), moderate to severe periodontitis patients (n =40), and healthy subjects (n = 40). Results The serum CRP levels in control group, moderate to severe periodontitis patients, CHD patients and patients with both diseases were (1.30 ± 0. 15), (2. 44± 0. 18), (5.99 ± 0. 82 ) and ( 6. 88± 0. 71 ) mg/L, respectively. The differences among these four groups were significant (P 〈 0. 001 ). The multivariate logistic regression revealed that moderate to severe periodontitis patients exhibited markedly elevated odds of having CHD ( OR = 2. 417, 95% CI: 1. 126- 6. 659). The total cholesterol levels were also significantly different among the four groups( P = 0. 017 ). Conclusions The moderate to severe periodontitis was associated with elevated serum CRP levels which may in turn affect the initiation and progression of CHD, and may be a risk factor for CHD.