不同类型侵袭性牙周炎患者牙周基础的临床治疗研究

目的探讨不同类型侵袭性牙周炎（AgP）患者牙周基础的临床治疗效果。方法回顾性分析2007年5月至2012年5月入住垫江县人民医院的100例AgP患者的临床资料,其中58例为广泛型AgP（G-AgP）,余下42例为局限型AgP（L-AgP）,对G-AgP与L-AgP两组患者进行牙周基础治疗。对两组治疗前后牙周探诊深度（PD）、附着水平（CAL）、探诊出血指数（BOP）,治疗前后血清中肿瘤坏死因子-α（TNF-α）、白细胞介素4（IL-4）水平以及治疗前后龈沟液中TNF-α、IL-4水平进行对比。结果①G-AgP组患者治疗前PD、CAL与BOP分别为（4.38±0.71）mm、（2.60±0.36）mm及（3.11±0.60）mm,治疗后分别为（2.33±0.31）mm、（1.29±0.21）mm及（2.02±0.39）mm,本组治疗前后上述指标的差异有统计学意义（均P〈0.05）;L-AgP组患者治疗前上述指标分别为（4.56±0.81）mm、（2.69±0.39）mm及（3.19±0.60）mm,治疗后分别为（2.45±0.37）mm、（1.39±0.28）mm及（2.22±0.41）mm,比较治疗前后的差异有统计学意义（均P〈0.05）,且L-AgP组治疗后与G-AgP组治疗后的指标相比,差异有统计学意义（P〈0.05）;②两组患者治疗前后血清中TNF-α、IL-4水平组内对比差异无统计学意义（P〉0.05）,但治疗后两组对比差异有统计学意义（P〈0.05）;③G-AgP组治疗前龈沟液中TNF-α、IL-4水平分别为（7.73±1.38）ng/L、（31.52±5.36）ng/L,治疗后分别为（3.72±0.91）ng/L、（61.83±16.52）ng/L,本组治疗前后上述指标差异具有统计学意义（P〈0.05）;L-AgP组治疗前上述指标分别为（7.97±1.52）ng/L、（33.37±11.09）ng/L,治疗后分别为（3.90±1.33）ng/L、（62.76±15.78）ng/L,本组治疗前后相比,差异具有统计学意义（均P〈0.05）。两组治疗后对比差异具有统计学意义（P〈0.05）。结论牙周基础治疗是侵袭型牙周炎患者临床治疗的一种有效的方法,应在临床上加以推广并应用。

Research on Clinical Periodontal Treatment of Patients with Different Types of Aggressive Periodontitis

Objective To explore the clinical effect of periodontal treatment on patients with different types of aggressive periodontitis（ AgP）. Methods The data of 100 cases of patients with aggressive periodontitis（ AgP） was retrospectively analyzed during May 2007 and May 2012,including 58 cases of general AgP（ G-AgP）,and 42 cases of localized AgP（ L-AgP）,the two groups were given periodontal therapy. Periodontal probing depth（ PD）,attachment level（ CAL）,bleeding on probing index（ BOP）,serum levels of TNF-α,IL-4,as well as the gingival sulcus fluid TNF-α,IL-4 level of the two groups before and after treatment were compared. Results ①G-AgP group before treatment PD,CAL and BOP were（ 4. 38 ± 0. 71） mm,（ 2. 60 ± 0. 36） mm and（ 3. 11 ± 0. 60） mm,after treatment,were（ 2. 33 ± 0. 31） mm,（ 1. 29 ± 0. 21） mm and（ 2.02 ±0.39） mm,the differences of the indicators in this group before and after treatment were statistically significant（ all P 0. 05）; L-AgP group before treatment,the corresponding indicators were（ 4. 56 ± 0. 81） mm,（ 2. 69 ± 0. 39） mm and（ 3. 19 ± 0. 60） mm,after treatment were（ 2. 45 ± 0. 37） mm,（ 1. 39 ± 0. 28） mm and（ 2. 22 ± 0. 41） mm,the difference were also statistically significant（ all P 0. 05）; and the indicators of L-AgP group and G-AgP group had statistically significant difference after treatment（ P 0. 05）; ②serum TNF-α,IL-4 level of the two groups before and after treatment were not statistically significantly different（ P 0. 05）,while the difference between the two groups after treatment was statistically significant（ P 0. 05）; ③G-AgP group TNF-α and IL-4 level in gingival sulcus fluid before the treatment were（ 7. 73 ± 1. 38） ng/L,（ 31. 52 ± 5. 36） ng/L,after treatment were（ 3. 72 ± 0. 91） ng/L,（ 61. 83 ± 16. 52） ng/L, the difference was statistically significant（ P 0. 05）; these indicators L-AgP group before treatment were（ 7.97 ±1.52） ng/L,（ 33.37 ±11.09） ng/L,after treatment were（ 3.90 ±1.33） ng/L,（ 62.76 ±15.78） ng/L, the difference of the same group before and after treatment was statistically significant（ all P 0. 05）. The differences between the two groups after treatment were also statistically significant（ P 0. 05）. Conclusion Periodontal treatment is an effective method for clinical treatment of invasive periodontitis,which should be promoted and applied in clinical practice.