高原地区重度牙周病与轻度认知障碍和阿尔茨海默病的相关性研究

发布时间：2018-03-21 17:52

  本文选题：高原地区　切入点：牙周病　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解高原地区轻度认知障碍(Mild Cognitive Impairment,MCI)和阿尔茨海默病(Alzheimer's disease,AD)与重度牙周病的相关性;探讨低氧环境下口腔慢性感染是否为MCI和AD的危险因素及其潜在机制。方法:收集2015年12月到2017年02月在青海省人民医院(海拔2,260m)老年病研究所和口腔科门诊的汉族重度牙周病患者和健康人群271例,给予认知量表筛查和牙周临床指标检查,按牙周病和认知障碍程度分成4组:正常对照组、重度牙周病组、重度牙周病+MCI组、重度牙周病+AD组。测定研究对象血清生化指标和牙周临床指标。采用ELISA方法测定血清、龈沟液IL-1β、IL-6的浓度,荧光定量PCR方法检测龈下菌斑中牙龈卟啉单胞菌(Pg)的检出率,所得数据进行统计学分析。结果:1.四组研究对象的性别、年龄和文化程度无显著差异(p0.05),四组在MMSE、Mo CA、ADAS-Cog认知量表评分比较差异有统计学意义(p0.05)。2.随着认知程度的加重,血清HCY呈上升趋势,差异有统计学意义(p0.05)。重度牙周病+AD组LDL-C较正常对照组升高,差异有统计学意义(p0.05);3.与对照组比较,随着牙周炎与认知的加重,三组牙周袋探诊深度(PD)、临床附着水平(CAL)和出血指数(BI)呈线性递增,重度牙周病+AD组增高显著。四组龈下菌斑中Pg总的检出率为65.68%,健康对照组为37.38%,重度牙周病组71.21%,重度牙周病+MCI组76.19%,重度牙周病+AD组94.23%,四组比较,差异有统计学意义(p0.05);4.与对照组比较,重度牙周病+AD组、重度牙周病+MCI组和重度牙周病组血清和龈沟液IL-1β、IL-6升高,差异有统计学意义(p0.05),重度牙周病+AD组与重度牙周病+MCI组IL-6明显高于重度牙周病组(p0.05)。同一炎症因子,在龈沟液的浓度较血清浓度高,差异有统计学意义(p0.05);5.对牙周临床指标、神经量表和IL-1β、IL-6进行相关分析,结果发现,PD、CAL与MMSE、Mo CA、CDT呈负相关(p0.01),PD、CAL与ADAS-Cog呈正相关(p0.01),PD、CAL与血清和龈沟液IL-1β、IL-6均呈正相关。结论:1.高HCY和LDL-C血症可能加重认知功能损害;2.高原地区重度牙周病合并MCI和AD患者Pg检出率高,两组血清和龈沟液IL-1β、IL-6明显高于正常组和重度牙周病组;3.低氧环境下重度牙周病和认知功能可能存在相互作用。
[Abstract]:Objective: To investigate the mild cognitive impairment in plateau area (Mild Cognitive Impairment, MCI) and Alzheimer's disease (Alzheimer's disease, AD) associated with severe periodontal disease; to investigate the effect of hypoxia environment oral chronic infection are risk factors for MCI and AD and its potential mechanism. Methods: from December 2015 to 2017 02 in Qinghai People's Hospital (altitude 2260m) Institute of geriatrics and outpatient department of Stomatology Han severe periodontal disease patients and 271 healthy people, given the cognitive scale screening and clinical indicators of periodontal examination, divided into 4 groups according to the periodontal disease and cognitive impairment: normal control group, severe periodontal disease group, severe periodontal disease group +MCI, severe tooth week +AD disease group. To determine the object of study of serum biochemical indexes and periodontal clinical parameters. The determination of serum by ELISA method, GCF IL-1 beta, IL-6 concentration, fluorescence quantitative PCR method for detecting the gums in subgingival plaque Gingivalis (Pg) detection rate, the data were statistically analyzed. Results: 1. of the four groups had no significant difference in gender, age and education level (P0.05), four in MMSE group, Mo CA, there were significant differences between the ADAS-Cog cognitive scale score (P0.05).2. with increasing cognitive degree the serum HCY increased, the difference was statistically significant (P0.05). Severe periodontal disease group +AD LDL-C increased compared to normal control group, the difference was statistically significant (P0.05; 3.) compared with the control group, with severe periodontitis and cognition, three groups of periodontal probing depth (PD), clinical attachment level (CAL) and bleeding index (BI) is a linear increase of severe periodontal disease in +AD group increased significantly. The four groups in the subgingival plaque Pg total detection rate was 65.68%, control group was 37.38%, severe periodontal disease group 71.21%, severe periodontal disease in 76.19% of +MCI group, severe periodontal disease +AD group 94.23%, four groups, 宸�寮傛湁缁熻�″�︽剰涔�(p0.05);4.涓庡�圭収缁勬瘮杈�,閲嶅害鐗欏懆鐥，

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