C-反应蛋白与牙周炎和冠心病的相关性的研究

发布时间：2018-05-05 05:24

  本文选题：牙周病 + 冠心病　； 参考：《山西医科大学》2014年硕士论文

【摘要】：目的 冠状动脉粥样硬化心脏病(AS,又可以称为冠心病,coronary heart disease, CHD)目前已可以说是首要影响人们身体健康和生存质量的疾病之一。慢性的牙周炎(CP)是一些细菌微生物潜伏在人口腔的牙周组织的周围,通过长时间不断地侵害和损伤,从而导致人体牙周组织的局部感染,造成牙周局部组织结构、功能的损伤,还可能会引发机体全身各个系统(如心血管系统)的损害。大量的研究成果都表现出慢性牙周病与冠心病之间的潜在联系,像吸烟,高血压,糖尿病,肥胖,血脂等都可以作为相近的影响因素,促进和增加两种疾病的患病率。牙周炎与冠心病其疾病的病理本质即为机体相应组织的炎症性感染,疾病的整体过程即为一场炎症反应,而C-反应蛋白(C-reactive protein, CRP)则是在炎症反应中是极其活跃而敏感的物质之一,他可能与两种疾病都存在密切地相关性。本课题通过研究CRP在血清中的分布,及其与血清学和牙周各指标的关系,探讨CRP与这两种疾病存在的某种相关性,和其在整个疾病病程中所起到的关键性作用。 方法 1.研究目标 选取2013.9月至2013.12月于山西省心血管医院心内科住院的首次确诊为冠心病的患者60例,其中冠心病伴牙周炎组(CP组)30例,单纯冠心病组(C组)30例,从省人民医院口内门诊和体检中心选择单纯慢性牙周炎患者30例,健康志愿者30例,分别为牙周炎组(P组),健康对照组(H组) 2.临床资料收集 2.1.一般常规性检查 对所有受试者均详细记录其年龄、性别、身高、体重、吸烟史、既往高血压史及全身系统病史等项目。所有入选者均接受血液生化检测,抽取清晨空腹静脉血,检测并将相关数据结果登记注册在案。具体登记结果包括：血清中的高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)和白细胞数(WBC)。 2.2.口腔专科检查 每一个受试者的口腔牙周系统组织进行详细全面的检查,测量代表牙的六个牙位点(即舌腭侧牙面的近中点、中间点和远中点,唇颊侧牙面的近中点、中间点和远中点),测得每个代表牙的牙周探诊深度(PD),龈沟出血指数(SBI),附着丧失(AL),分别将相应指标登记在案。 2.3.血清CRP检测 对所有受试者进行抽血化验,取早晨的空腹静脉血,选用免疫比浊法检测血清hs-CRP,并登记结果。 结果： 1.常规临床指标结果： 四组间性别、HDL、FPG间无明显差异(P0.05)。所有患者组血清白细胞数都明显高于健康对照组,且为有意义的统计学差异(P0.05)。血清TC、TG、LDL在冠心病伴牙周炎组和单纯冠心病患者组中明显高于牙周炎组和健康组,且差异有统计学意义(P0.05)。 2.牙周指标结果： 四组中牙周各指标(探诊深度PD、龈沟出血指数SBI、附着丧失AL)存在显著差异,且差异具有统计学意义(P0.001)。PD、SBI、AL在冠心病伴牙周炎组和单纯慢性牙周炎组中都明显高于单纯冠心病组和健康参照组,且差异有统计学意义(P0.05)。 3.血清CRP浓度结果： 四组中血清CRP存在明显差异,且均为有意义的统计学差异(P0.001)。其中,冠心病伴牙周炎组血清CRP高于慢性牙周炎组(PO.05),慢性牙周炎组高于冠心病组(P0.05),冠心病组高于健康参照组(P0.05)。 4.临床血清学指标和各牙周指标的相关性： 血清WBC与牙周指标PD、SBI、AL均存在正相关关系,相关系数r和P值分别为：r=0.500,P0.001;r=0.521,P0.001;r=0.555, P0.001。 5.血清CRP和各牙周指标的相关性： 血清CRP与牙周指标PD、SBI、AL均相关,且为正相关,相关系数r和P值分别为：r=0.500, P0.001;r=0.635, P0.001;r=0.702, P0.001。 6.血清CRP和临床血清学指标的相关性： 血清CRP与WBC相关,并且是正相关,相关系数r=0.500,P0.001。 结论： 1.血清CRP的水平由高到低依次为：冠心病伴牙周炎组、单纯牙周炎组、冠心病组、健康组。说明CRP在冠心病和牙周炎的发生中起一定作用,牙周炎引起CRP水平增高。 2.CRP与牙周指标存在相关性,说明CRP水平升高,牙周炎程度加重。
[Abstract]:objective
Coronary atherosclerotic heart disease (AS, also known as coronary heart disease, coronary heart disease, CHD) is now one of the most important diseases that affect the health and quality of life of the people. Chronic periodontitis (CP) is a bacterial microorganism that lurks around the periodontal tissue of the human mouth and is violated and damaged for a long time. Injury, which leads to local infection in the periodontal tissue of the human body, causes local tissue structure, function damage, and may cause damage to various systems (such as cardiovascular system) of the body. A large number of research results show the potential link between chronic periodontitis and coronary heart disease, such as smoking, hypertension, diabetes, obesity, blood lipid and so on. As a similar influence factor, it can promote and increase the prevalence of two diseases. The pathological nature of periodontitis and coronary heart disease is inflammatory infection of the body's corresponding tissues, the whole process of the disease is an inflammatory response, and the C- reactive protein (C-reactive protein, CRP) is extremely active and sensitive in the inflammatory response. One of the substances of sensation may be closely related to the two diseases. By studying the distribution of CRP in the serum and its relationship with the serology and periodontal indexes, this topic explores the correlation between CRP and the existence of these two diseases, and the key role it plays in the course of the disease.
Method
1. research goals
60 cases of coronary heart disease were first diagnosed as coronary heart disease in the Department of Cardiology of Shanxi cardiovascular hospital from 2013.9 to 2013.12 months, including 30 cases of coronary heart disease and periodontitis group (group CP) and 30 cases of simple coronary heart disease group (group C). 30 cases of single chronic periodontitis were selected from the out-patient and physical examination center of the provincial people's Hospital, and 30 cases of healthy volunteers were selected, respectively. Periodontitis group (group P), healthy control group (group H)
2. clinical data collection
General routine examination of 2.1.
All subjects were recorded in details of their age, sex, height, weight, smoking history, history of hypertension and systemic history. All the participants received blood biochemical tests, extracted the early morning venous blood, checked and registered the results of the related data. The specific registration results included the high density fat eggs in the serum. White (HDL-C), low density lipoprotein (LDL-C), total cholesterol (TC), triglyceride (TG), fasting blood glucose (FPG) and white blood cell count (WBC).
2.2. stomatological examination
A detailed and comprehensive examination of the periodontal tissue of each of the subjects was carried out to measure six dental sites representing the teeth (the middle point of the tongue and the palate side, the middle point and the far middle point, the middle point, the middle point and the far middle point of the cheek and cheek teeth, the PD), the gingival gingival bleeding index (SBI), and the loss of attachment (AL). The corresponding indicators are registered on the case.
Detection of serum CRP in 2.3.
Blood samples were taken from all subjects. Fasting venous blood was taken in the morning. Serum hs-CRP was detected by immunoturbidimetry and the results were registered.
Result锛，

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