老年中重度牙周炎伴2型糖尿病患者牙周基础治疗的作用分析

目的：探讨老年中重度牙周炎伴2型糖尿病患者牙周基础治疗对牙周感染的控制效果。方法：选取2018年9月至2019年9月上海市浦东医院收治的老年中重度牙周炎伴2型糖尿病患者60例,随机分为对照组（n=30,不进行牙周基础治疗）和观察组（n=30,进行牙周基础治疗）,均进行口腔卫生宣教和生活方式干预。评价2组患者治疗后的牙周参数（菌斑指数、龈沟出血指数、牙周袋深度及附着丧失）、血糖指标[空腹血糖（FPG）、餐后2 h血糖（2hPG）及糖化血红蛋白（HbA₁c）]、牙周感染控制率和治疗服务满意率,并对牙周参数与HbA₁c行相关性分析。结果：观察组治疗后,菌斑指数、出血指数、牙周袋深度及附着丧失等参数均小于对照组（P<0.05）;FPG、2hPG、HbA₁c水平均小于对照组（P<0.05）;牙周感染控制率高于对照组（P<0.05）;菌斑指数、出血指数、牙周袋深度及附着丧失与HbA₁c正相关（r²=0.844、0.900、0.932、0.866;P<0.05）;观察组治疗满意率高于对照组（96.67%vs 70.00%,P<0.05）。结论：对老年中重度牙周炎伴2型糖尿病患者应及时行临床系列牙周基础治疗,有利于控制牙周感染,改善患者血糖指标,减少老年患者感染,提高老年患者生活与生存质量,为跨学科治疗老年2型糖尿病提供新的思路与方法。

Effect of periodontal basic treatment in elderly patients with moderate to severe periodontitis and type 2 diabetes

Objective: To explore the effect of periodontal basic treatment on periodontal infection in elderly patients with moderate to severe periodontitis and type 2 diabetes.Methods: 60 elderly patients with moderate to severe periodontitis and type 2 diabetes admitted to Shanghai Pudong Hospital from September 2018 to September 2019 were divided into control group (patients did not receive periodontal basic treatment, n=30) and observation group (patients received periodontal basic treatment, n=30) randomly. All patients'' periodontal parameters (plaque index, sulcus bleeding index, periodontal pocket depth and attachment loss), blood glucose index (fasting blood glucose (FPG), 2-hour postprandial blood glucose (2hPG), and glycated hemoglobin (HbA_lc)), periodontal infection control rate, and treatment service satisfaction rate were evaluated. The correlation between periodontal parameters and HbA₁c was analyzed.Results: the parameters of plaque index, sulcus bleeding index, periodontal pocket depth, and attachment loss in the observation group were significantly lower than those in the control group (P<0.05); the levels of FPG, 2hPG, and HbA_lc in the observation group were significantly lower than those in the control group (P<0.05). The control rate of periodontal infection was higher than that of the control group (P<0.05); The correlation analysis between periodontal index and HbA1c in the observation group showed that plaque index, bleeding index, periodontal pocket depth and attachment loss were positively correlated with HbA₁c (r²=0.844, 0.900, 0.932, 0.866; P<0.05). the treatment satisfaction rate of the observation group was higher than the control group (96.67% vs 70.00%, P<0.05). The periodontal parameters were positively correlated with HbA₁c in observation group (P<0.05).Conclusions: Basic periodontal treatment is beneficial to control periodontal infection, improve the blood glucose index of the patients and improve the quality of medical service, which might provide new ideas and methods for interdisciplinary treatment of elderly type 2 diabetes.