2019 年第 12 期 第 14 卷

牙周基础治疗对维持性血液透析患者全身及局部炎症状态的影响

Effect of periodontal non-surgical treatment on systemic and local inflammation in patients with maintenance hemodialysis

作者：陈天怡杨洁白鸣霞赵敬娜王艳艳左力

英文作者：

单位：100096北京积水潭医院肾内科（陈天怡、杨洁），口腔科（白鸣霞）；102206北京大学国际医院血液净化中心（赵敬娜）；100029首都医科大学附属北京安贞医院肾内科（王艳艳）；100044北京大学人民医院肾内科（左力）

英文单位：

关键词：维持性血液透析；慢性牙周炎；炎症；牙周基础治疗

英文关键词：

• 摘要：

• 【摘要】目的    探讨合并中重度慢性牙周炎的维持性血液透析患者行牙周基础治疗对全身和口腔局部炎症状态的影响。方法    选取2017年11月至2018年5月北京积水潭医院、北京大学国际医院、北京王府中西医结合医院行维持性血液透析、且合并中重度牙周炎患者29例。收集入组患者基线状态和牙周基础治疗后3个月的血液和龈沟液标本，采用酶联免疫吸附试验法检测C反应蛋白（CRP）和白细胞介素6（IL-6），分析治疗前后血液和龈沟液中上述指标的变化情况。结果    共17例患者完成本研究。牙周基础治疗后3个月血清CRP水平较基线值明显降低［1.4（0.5，3.4）mg/L比2.3（0.7，5.5）mg/L］，差异有统计学意义（P＝0.043）；血清IL-6水平有下降趋势，但差异无统计学意义（P＞0.05）；龈沟液CRP和IL-6水平与基线值比较差异均无统计学意义（均P＞0.05）。结论    维持性血液透析合并中重度牙周炎患者经牙周基础治疗后全身炎性反应较治疗前好转，口腔局部炎症状态尚未发现明显改善。

• 【Abstract】Objective    To investigate the effect of periodontal non-surgical treatment on systemic and oral inflammation in patients with moderate to severe chronic periodontitis undergoing maintenance hemodialysis. Methods    Twenty-nine patients with moderate to severe chronic periodontitis who underwent maintenance hemodialysis in Beijing Jishuitan Hospital, Peking University International Hospital and Beijing Royal Integrative Medicine Hospital were enrolled from November 2017 to May 2018. Blood and gingival crevicular fluid samples were collected before and 3 months after periodontal non-surgical treatment. C-reactive protein（CRP）and interleukin-6（IL-6） were detected by enzyme linked immunosorbent assay. Results    Seventeen patients completed the study. Three months after periodontal treatment, serum CRP concentration was significantly lower than the baseline［1.4（0.5，3.4）mg/L vs 2.3（0.7，5.5）mg/L］ （P＝0.043）; serum IL-6 concentration decreased compared with the baseline, but the difference was not statistically significant（P＞0.05）. Concentrations of CRP and IL-6 in gingival crevicular fluid after treatment showed no significant differences compared with the baseline（both P＞0.05）. Conclusion    In maintenance hemodialysis patients with moderate to severe periodontitis, systemic inflammatory response can be improved after periodontal non-surgical treatment, but no significant improvement is found in local oral inflammation.