冠状动脉粥样硬化斑块中牙周炎致病菌的检测

目的探讨牙周炎与冠状动脉粥样硬化性心脏病（以下简称冠心病）发病的相关机制。方法收集31例行冠状动脉搭桥手术并伴有牙周炎的患者冠状动脉粥样硬化斑块和龈下菌斑，采用Chelex-100法提取细菌DNA，以聚合酶链反应（PCR）法检测冠状动脉粥样硬化斑块和龈下菌斑中牙龈卟啉单胞菌（Porphyromonas gingivalis，Pg）、伴放线放线杆菌（Actinobacillus actinomycetemcomitans，Aa）、具核梭杆菌（Fusobacterium nucleatum，Fn）、中间普氏菌（Prevotella intermedia，Pi）、福赛拟杆菌（Bacteroides forsythus，Bf）5种牙周炎相关致病菌。结果在31例患者冠状动脉粥样硬化斑块中，各种牙周炎相关致病菌的检出率分别为：Pg 38．7％、Aa 0％、Pi 12．9％、Fn 22．6％、Bf 38．7％；在本组同一患者冠状动脉粥样硬化斑块及龈下菌斑中同时检出Pg 5例、Aa 0例、Pi 2例、Fn 4例、Bf 8例，一致率分别为Pg 16．1％、Aa 0％、Pi 6．5％、Fn 12．9％、Bf 25．8％。结论在冠状动脉粥样硬化斑块中牙周炎相关致病菌DNA的检出，提示牙周炎相关致病菌在冠心病的发生、发展中可能起着重要的作用，为冠心病危险因素的研究和冠心病防治策略的制定提供了参考依据。

Detection of periodontal pathogens in coronary atherosclerotic plaques

OBJECTIVE: To explore the possible correlation between coronary heart disease and periodontitis. METHODS: Subgingival plaque samples and coronary atherosclerotic plaques were harvested from a total of 31 patients with periodontitis who scheduled for coronary artery bypass surgery. The bacteria DNA was obtained from subgingival plaque samples and coronary atherosclerotic plaques using the chelex-100 method. The extracted DNA was examined using the polymerase chain reaction (PCR) technique. RESULTS: In coronary atherosclerotic plaques samples from the 31 patients, Porphyromonas gingivalis (Pg, 38.7%), Actinobacillus actinomycetemcomitans (Aa, 0%), Fusobacterium nucleatum (Fn, 22.6%), Prevotella intermedia (Pi, 12.9%), Bacteroides forsythus (Bf, 38.7%) were detected. The concordant presence of the same periodontal bacteria DNA in subgingival plaques and in coronary atherosclerotic plaques in the same patient was Pg 5 (16.1%), Aa 0 (0%), Pi 2 (6.5%), Fn 4 (12.9%) and Bf 8 (25.8%). CONCLUSIONS: The presence of periodontal bacteria DNA in coronary atherosclerotic plaques could indicate that periodontal pathogenic bacteria may play a role in the coronary heart disease process.