钙离子拮抗剂致药物性牙龈增生的危险因素分析

目的：探讨高血压患者服用钙离子拮抗剂后出现牙龈增生的患病率。方法：对我院查体中心和心血管内科门诊服用钙离子拮抗剂抗高血压类药物的262和未服用钙离子拮抗剂的197例患者进行横断面调查。方法包括问卷调查和口腔牙周检查,其中牙龈增生的判定以牙龈增生指数（HI ）为诊断标准。对调查结果进行统计学分析。结果：服用钙离子拮抗剂类药物患者的牙龈增生患病率为20．23％,显著高于对照组的2．54％（χ2＝32．276,P＜0．05）。随年龄增大,药物性牙龈增生的患病率降低（r＝－0．155,P＜0．05）;单一用药者较联合用药者患病率高;服药时间越长患病率降低;随服药剂量的增加,患病率明显增长;口腔卫生状况差者可加重牙龈增生程度。结论：药物性牙龈增生是多方面作用的结果,其主要影响因素为患者年龄、服药方式、剂量、时间和牙周局部因素。     

硝苯地平性牙龈增生组织中成纤维细胞增殖和胶原分泌

目的探讨硝苯地平对牙龈组织中成纤维细胞增殖和胶原分泌的影响。方法体外原代培养硝苯地平易感性牙龈组织和非易感性组织中人牙龈成纤维细胞。MTT法观察硝苯地平对细胞增殖的影响,酶联免疫吸附试验检测硝苯地平对细胞Ⅰ型胶原表达水平的影响。结果在第1,3,5天,硝苯地平易感性牙龈组织和非易感性组织之间Ⅰ型胶原合成和细胞增殖在统计学上均有显著性差异。结论细胞增殖明显和胶原合成增加可能和硝苯地平药物性牙龈增生机制有关。     

硝苯地平介导药物性牙龈增生的研究进展

药物性牙龈增生(DGO)是临床常见性牙周疾病.硝苯地平(NIF)为第1代钙离子拮抗剂,其副作用可引发DGO.在NIF介导的DGO中,与程序性细胞死亡相关的调节基因B细胞淋巴瘤/白血病-2基因和c-myc以及转录因子又头框蛋白在抑制细胞程序性死亡的过程中起重要作用.成纤维细胞表面所表达的补体受体具有异质性,与DGO的发生密切相关.炎症因子和黏附分子对DGO的作用也不可忽视.下文就近年来NIF介导DGO的国内外相关研究进展作一.     

硝苯地平药物不良反应致牙龈增生6例

临床资料:6例病人均为男性,年龄43~70岁。服药时间最短1年,最长4年。6例病人停药后牙龈增生均有明显好转及改善。现将典型病例详述如下:患者男,70岁。患高血压,2002年服用硝苯地平控释片(拜欣同)60 mg/d。2004年改换服用硝苯地平缓释片(尼福达)20 mg/次2次/d。据病人口述此时牙龈已有增生其增生组织质地坚韧略有弹性,呈粉红色不易出血。探查牙周袋深约6mm,龈上结石( ),牙齿不松动,牙龈黏膜无破溃,自述刷牙时无出血。既往无药物过敏史,除牙龈组织增生外,无下肢浮肿。除患高血压外无其它慢性疾病。临床诊断:硝笨地平引起的药源性牙龈肥厚(增生…     

唾液中IL-6与硝苯地平所致药物性牙龈增生的关系

目的探讨硝苯地平所致药物性牙龈增生程度与非刺激性全唾中IL-6水平之间的关系。方法从北京石景山社区服用硝苯地平6个月以上的205名个体中,按照增生指数分层,随机抽取66名个体作为本研究的评价对象,并完成以下检查：一般检查包括身高,体重;牙周临床检查包括菌斑指数（Plaqueindex,PLI）,探诊深度（Probing Depth,PD）,探诊出血指数（Bleedingindex,BI）,附着丧失（Attachment Loss,AL）。实验室检查：抽取受检者空腹前臂静脉血,采用全自动分析仪检测空腹血糖（Fasting Plasma Glucose,FPG）,并收集非刺激性全唾,用ELISA法检测唾液中IL-6水平。拍摄每位受检者前牙区数码相,评价每位受检者的牙龈增生指数（Gingival Overgrowth Score,GOS）。结果牙龈增生程度由低到高分为五组,各组IL-6水平（x±SD）分别为4．72±1．20pg／ml,10．77±2．79pg／ml,11．21±2．83pg／ml,15．424±3．12pg／ml,29．82±12．61pg／ml。Pearson检验显示非刺激性全唾中的IL-6水平与牙龈增生指数显著相关（P〈0．05,r=0．604）。应用SPSS13．0分析软件控制BI,PD,BMI,Glu,PLI,AL后,偏相关分析显示,非刺激性全唾中IL-6水平仍与牙龈增生指数正相关（P〈0．05,r=0．379）。结论非刺激性全唾中IL-6水平与硝苯地平所致的牙龈增生有关。     

硝苯地平性牙龈增生的临床研究

目的 研究服用硝苯地平患者牙龈增生的发病情况。方法 对75名服用硝苯地平患者作牙周检查。并与134名非服用者作对照。结果 服用硝苯地平患者牙龈增生的发病率和发病严重程度均明显较对照组高。结论 提示服用硝苯地平是导致牙龈增生的重要原因。     

钙离子拮抗剂致老年人牙龈增生危险因素分析

目的:数据分析西安交通大学医院内科门诊的高血压或其他心血管疾病患者服用的钙离子拮抗剂对诱导牙龈增生的影响.方法:经筛选后符合此次调研标准的2019年我院内科门诊的高血压或其他心血管疾病的临床资料共483份,其中服用钙离子拮抗剂(Calcium Channel Blockers,CCB)者252例,未服用CCB(对照组)...     

钙离子拮抗剂致药物性牙龈增生的危险因素分析

目的调查高血压患者服用钙离子拮抗剂后引起药物性牙龈增生的患病率,并分析其危险因素。方法将北京医院心血管内科的681例高血压或冠心病患者纳入本研究,其中330例服用钙离子拮抗剂(CCB组),351例未服用钙离子拮抗剂(对照组)。记录患者的性别、年龄、用药种类、持续时间、剂量、是否联合用药。临床检查牙龈出血指数(BI)、菌斑指数(PLI)、牙龈增生指数(HI)。结果服用钙离子拮抗剂组牙龈增生的患病率为41.21%,显著高于对照组4.84%(P<0.05)。对调查的各种因素进行Logistic回归分析,结果显示:BI(OR=2.17,95%可信区间:1.60-2.94)PLI(OR=1.99,95%可信区间:1.38-2.87)是患者出现牙龈增生的危险因素。结论口腔卫生状况和牙龈炎症反应是药物性牙龈增生的危险因素。     

硝苯地平导致牙龈增生机制的研究

目的:在牙龈成纤维细胞(gingival fibroblasts(GFs))与牙龈角质形成细胞(gingival kerati-nocytes,GKs)共培养下,研究硝苯地平导致牙龈增生的可能机制。方法:用不同浓度(0、0.2、20μg/mL)硝苯地平处理GFs和GKs的共培养体系,3 d后用逆转录PCR、酶联免疫吸附实验以及流式细胞计数等方法观察角质细胞生长因子(keratinocyte growth factor,KGF)及其受体(keratinocyte growth factor receptor,KGFR)的表达。结果:在共培养条件下,硝苯地平导致GFs表达KGF显著增高,并呈浓度依赖性。同时硝苯地平能促进GKs中KGFR基因表达上调,膜KGFR蛋白表达水平在硝苯地平浓度为0.2μg/mL时上调。结论:间充质-上皮作用途径之一的角质细胞生长因子-受体间相互影响,在硝苯地平导致牙龈增生中起着一定的作用;体外GFs-GKs共培养模型能够在更接近体内环境的状态下进一步研究牙龈增生的机制。     

药物性牙龈增生发病机制的研究进展

药物性牙龈增生是指服用抗癫痫药、钙通道阻滞剂和免疫抑制剂等某些特定药物引起的牙龈增生和体积增大,具有共同的病理组织学特点,其发病机制目前仍无定论。下面就药物性牙龈增生在胶原的合成与降解失衡、上皮细胞的增殖和程序性细胞死亡以及上皮下炎症浸润机制上取得的研究进展作一综述。     

Nifedipine pharmacological variables as risk factors for gingival overgrowth in organ-transplant patients

The prevalence and severity of gingival overgrowth in organ-transplant patients medicated with cyclosporin are greater in patients concomitantly medicated with nifedipine; however, no relationship between the gingival overgrowth and any of the nifedipine pharmacological variables has been demonstrated. The study examined the effect of five nifedipine pharmacological variables (nifedipine dosage, plasma concentration and gingival crevicular fluid concentration, M1 metabolite plasma concentration and the nifedipine:M1 ratio). The effect of the nifedipine variables on the gingival overgrowth score were examined using univariate and multivariate regression analysis. Adjustment for the effect of other risk factors was made by adding the distribution of each of the nifedipine variables in turn to a stepwise regression model containing previously identified risk factors for this condition. Despite the high levels of nifedipine sequestered in the GCF, only the plasma concentration of nifedipine was identified as a risk factor for the severity of gingival overgrowth in these patients (P = 0.01) once adjusted for other known risk factors (r ² for the model = 55%).     

硝苯地平对牙龈成纤维细胞增殖和DNA合成的影响

目的：研究钙离子通道拮抗剂硝苯地平对人牙龈成纤维细胞的影响,方法：以硝苯地平1200．0、360．0、108．0和32．4μg/L作体外培养牙龈成纤维细胞细胞计数观察,并以^3H-胸腺嘧啶脱氧核苷（^3H-TDR)细胞内掺入法评价DNA合成量。结果：细胞计数在实验的第6、7d组间差异有极显著性。主要表现为硝苯地平1200．0μg/Lt 360.0μg/L组,细胞计数明显高于低浓度组,各组间DNA合成量差异有极显著性。进一步分析差异存在于高浓组织与其他各之间。结论：高浓度硝苯地平有刺激牙龈成纤维细胞增殖的作用。     

钙通道阻滞剂导致牙龈增生的Meta分析

目的 钙通道阻滞剂(CCB)是治疗心血管疾病的常用药物,文献报道其所致药物性牙龈增生(DIGO)的患病率为7.3％～77.6％,不同文献得出的结果差别较大,本研究旨在通过系统综述及Meta分析,以明确CCB与DIGO的关系及其影响因素.方法 两位不同的研究者分别系统地搜索了PubMed、Cochrane Library...     

服用硝苯地平后牙龈增生以及未增生患者牙龈成纤维细胞生物特性比较

目的：观察服用硝苯地平后牙龈增生和未增生患者牙龈成纤维细胞（nifedipine responders gingival fibro-blasts NIFr-HGF,nifedipine non-responders gingival fibroblasts NIFn-HGF）超微结构、细胞周期变化以及增殖能力的差异性,以探讨该药导致牙龈增生的可能作用机理。方法：采用透射电镜观察NIFr-HGF、NIFn-HGF的超微结构,利用流式细胞仪、MTT法检测和比较2种细胞经硝苯地平诱导后其细胞周期以及增殖能力的差异性。结果：与NIFn-HGF相比较,NIFr-HGF内粗面内质网扩张;受硝苯地平诱导后其增殖明显加强。结论：NIFr-HGF合成蛋白质的能力可能较NIFn-HGF强,且前者对于硝苯地平的反应也明显强于后者,这提示两类细胞的细胞生物学特性以及对钙离子拮抗剂的反应能力存在差异,药物性牙龈增生的发生可能存在细胞异质性。     

Clinical and pharmacological variables as a risk factor for nifedipine-induced gingival overgrowth

BACKGROUND: Gingival enlargement is usually noted within one to two months after the initiation of nifedipine therapy. The aetiology of nifedipine-induced gingival overgrowth is uncertain. The aim of this study was to determine the relationship between plasma and gingival crevice fluid (GCF) nifedipine concentrations and the degree of gingival overgrowth in patients treated with nifedipine, and also to assess the correlations between clinical and pharmacological variables. METHODS: Eighteen patients taking nifedipine in regular doses for at least six months participated in the study. Gingival enlargement was evaluated with two indices to score vertical and horizontal overgrowth. Gingival index (GI), plaque index (PI), gingival bleeding time index (GBTI), probing depth (PD) and clinical attachment level (CAL) were also evaluated. GCF and plasma nifedipine concentrations were determined by using high performance liquid chromatography. RESULTS: There was no significant difference between responders and non-responders for PI, GI and GBTI. The mean concentration of nifedipine in GCF was significantly greater than concentration in plasma. No significant difference was observed for GCF and plasma nifedipine concentration between responders and non-responders. CONCLUSIONS: The present study showed that neither GCF nor plasma nifedipine levels appeared to be a risk factor for nifedipine-induced gingival overgrowth. Improving the oral hygiene in patients using nifedipine may help control the degree of drug-induced gingival enlargement.     

硝苯地平引起牙龈增生20例临床观察

目的 观察服用硝苯地平引起的牙龈增生。方法 门诊随机观察与服用硝苯地平有关的牙龈增生病人20例,并了解停药前后的变化。结果 20例牙龈增生病人,通过停药和局部治疗,6月后随访,局部症状有所缓解。结论 服用硝苯地平可引起牙龈增生。     

Dental cross-bite and gingival marginal recession. A cross-sectional study

BackgroundCrossbite (CB) has been reported to be associated with Gingival Marginal Recession (GMR) especially in the anterior region. The current study aims to evaluate the association between GMR and CB both in anterior and posterior regions.Materials and methodsThis was a cross-sectional study in a private dental clinic in Najran, Kingdom of Saudi Arabia involving 120 medically healthy patients with CB, good to fair oral hygiene, non-severe gingival inflammation and without prosthesis. Socio-demographic data was obtained from the clinic records and diagnosis of cross-bite and GMR was made. The diagnosis of GMR was made with periodontal probe. Oral hygiene index (OHI) and Gingival index (GI) was also evaluated.ResultsAll the 120 cases of CB had at least 1 tooth with GMR. There were 55 (45.8%) males and 65 (54.2%) females with a M:F of 0.8:1. Age ranged from 11 to 50 years with Mean ± SD (21.78 ± 7.63). Age group < 30 years constitute the majority of the patients. The value of Odd’s ratio (OR) is much higher than 1.0 in all the lower anteriors (41, 41, 43, 31, 32 and 33), and statistically significant as compared with much lesser OR values for some of the upper anteriors (21, 22 and 23). Similar findings was also observed in the posterior dentition. Females tend to have better OHI and GI than males with statistical significance in the GI only (p = 0.048).ConclusionAssociation between CB and GMR especially in the lower anterior and posterior dentition was observed.     

非洛地平致牙龈增生3例报告及相关文献复习

本文报告了3例因服用非洛地平而致牙龈增生的病例,在停用(或减量)该药物及牙周治疗后,牙龈增生消退,形态恢复正常。作者复习了相关文献,并对药物性牙龈增生的发生机制和预防治疗进行了讨论。