牙周炎基础治疗前后龈沟液中两种因子水平的变化及盐酸米诺环素对治疗效果的影响

发布时间：2018-04-13 22:16

本文选题：牙周炎 + 基础治疗　；参考：《大连医科大学》2014年硕士论文

【摘要】：目的：分析比较慢性牙周炎患者牙周基础治疗前后,龈沟液中弹性蛋白酶(EA)和前列腺素E2(PGE2)水平的变化,以及盐酸米诺环素药物辅助治疗对龈沟液中两种因子水平的影响。方法：选择25个牙周炎患者,选择标准为左右半口各有超过5个位点有3毫米(mm)以上的牙周袋深度以及1mm以上的附着丧失,在左半口和右半口各选择3个符合标准的位点,对所选择的位点进行牙周临床检查,记录探诊深度(PD),附着丧失(AL),牙龈指数(GI),用滤纸收集两侧所选位点的等量的龈沟液,并记录收集龈沟液所需的时间(GCFtime),于室温下,将收集到龈沟液的滤纸置于PBS缓冲液中震荡一个小时,后于1000r/min的离心机中离心5分钟(min),取上清液于EP管中,放置于-70度冰箱中保存。取完龈沟液的患者进行牙周基础治疗,即超声波洁治和龈下刮治根面平整,选择每一个患者的右侧位点在基础治疗后使用盐酸米诺环素(派力奥)药物局部辅助治疗,左侧不用药,每周用药一次,共用药四次。基础治疗后约6周后,对患者进行同样位点的牙周临床检查,记录所需牙周指标,和同样方法的治疗后取样。约半年后,收集完毕所有患者治疗前后的龈沟液,取出所有保存样品,于室温下升温至室温。采用酶联免疫法(ELISA法)测量样品PGE2和EA的浓度,用spss13.0配对样品T检验对实验结果进行数据分析。结果：治疗后的PD, AL,GI均较治疗前明显降低,结果有统计学意义(P0.01)；治疗后的GCFtime较治疗前明显延长,结果有统计学意义(P0.01)；而治疗前后的PD, AL, GI, GCFtime的用药侧治疗前后的差值和非用药侧治疗前后的差值对比则无明显差别(P0.05)；对于龈沟液EA,牙周基础治疗后,用药侧和非用药侧水平均较治疗前明显降低,结果有统计学意义(P0.01)；但用药侧在治疗前后的差值与非用药侧在治疗前后的差值对比无明显差异,经统计学分析,结果无统计学意义(P0.05)；对于PGE2,牙周基础治疗后,用药侧和非用药侧水平也分别较治疗前明显降低,结果有统计学意义(P0.01)；但用药侧在治疗前后的差值与非用药侧在治疗前后的差值对比无明显差异,经统计学分析,结果无统计学意义(P0.05)。结论：对于慢性牙周炎患者,牙周基础治疗可有效降低龈沟液中PGE2和EA的浓度水平,这两种因子也可以作为评价牙周病严重程度和基础治疗效果的参考标准,然而盐酸米诺环素对牙周临床指标和两种因子在龈沟液中浓度无明显影响,对牙周炎的治疗为辅助作用。
[Abstract]:Objective: to compare the changes of the levels of elastase EAA and PGE2 in gingival crevicular fluid before and after basic periodontal treatment in patients with chronic periodontitis and the effect of minocycline hydrochloride drug adjuvant therapy on the two factors in gingival crevicular fluid.Methods: Twenty-five patients with periodontitis were selected according to the criteria of periodontal bag depth and loss of attachment above 1mm if there were more than 5 loci in the left and right halves, and 3 sites in the left and right halves, respectively.Periodontal clinical examination was performed on the selected sites, the depth of probing was recorded, the attachment loss of ALP, the gingival index (GI), the equivalent amount of gingival crevicular fluid at the selected sites were collected with filter paper, and the time required to collect gingival crevicular fluid was recorded, and at room temperature, the time required to collect gingival crevicular fluid was recorded.The filter paper collected from gingival crevicular fluid was placed in PBS buffer for one hour, then centrifuged in 1000r/min centrifuge for 5 minutes. The supernatant was collected in EP tube and stored in -70 degree refrigerator.Patients with gingival crevicular fluid were treated with basic periodontal therapy, namely ultrasonic scaling and subgingival curettage, and the right side of each patient was selected to receive local adjuvant therapy with minocycline hydrochloride (pariac) after basic treatment.The left side did not use drugs, once a week, a total of four times.After 6 weeks of basic treatment, periodontal clinical examination at the same site was performed, the required periodontal indexes were recorded, and samples were taken after the same treatment.After about half a year, the gingival crevicular fluid was collected from all patients before and after treatment, and all preserved samples were taken out and heated to room temperature at room temperature.The concentrations of PGE2 and EA were measured by Elisa. The experimental data were analyzed by spss13.0 paired sample T test.Results: after treatment, the PDand Algai were significantly lower than those before treatment, the results were statistically significant (P 0.01), and the GCFtime after treatment was significantly longer than that before treatment.The results showed that there was no significant difference in the difference between the two sides before and after treatment (P 0.05), and in the gingival crevicular fluid (EAA), after basic periodontal treatment, there was no significant difference between the difference before and after the treatment and the difference between the two sides before and after treatment (P 0.05), while the difference between the two sides before and after treatment was not significant (P 0.05).The level of drug side and non drug side were significantly lower than those before and after treatment, the results were statistically significant (P 0.01), but there was no significant difference between the drug side before and after treatment and the non-medication side before and after treatment.Results there was no statistical significance (P 0.05). For PGE2, the levels of the drug side and the non-medication side were significantly lower than those before the treatment.Results there was no significant difference in the difference between the drug side before and after treatment and that of the non-medication side before and after treatment, but there was no significant difference in the difference between the drug side and the non-medication side before and after treatment. The results showed that there was no significant difference in the difference between the drug side and the non-medication side before and after treatment.Conclusion: for patients with chronic periodontitis, periodontal basic therapy can effectively reduce the concentration of PGE2 and EA in gingival crevicular fluid. These two factors can also be used as reference criteria for evaluating the severity of periodontal disease and the effect of basic treatment.However, minocycline hydrochloride has no effect on periodontal clinical indexes and two factors in gingival crevicular fluid.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.4

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