牙周基础治疗对伴2型糖尿病的中、重度牙周炎患者牙周炎症控制、血清炎症指标及代谢水平影响

目的 探讨牙周基础治疗对伴 2型糖尿病的中、重度牙周炎患者牙周炎症控制、血清炎症指标以及糖代谢水平的影响。方法 将前期临床试验人群中的 56例中、重度牙周炎患者（平均临床附着水平> 3 mm）纳入本研究进行亚组分析，采用重复测量的方差分析比较治疗组和对照组牙周指数（包括平均探诊深度、临床附着水平和探诊出血指数）、超敏 C反应蛋白（ hsCRP）、糖化血红蛋白（ HbA1c）、空腹血糖在基线、 1.5个月、 3个月、 6个月连续 4次的变化。结果 伴2型糖尿病的中、重度牙周炎患者在牙周治疗后平均探诊深度（ F=62.898，P=0.000）、临床附着水平（ F=51.263，P=0.000）和探诊出血指数（ F=75.164，P=0.000）在治疗后逐渐改善，其中平均探诊深度（t=-2.050，P=0.045）和探诊出血指数（ t=-4.538，P=0.000）显著优于对照组；治疗后 hsCRP（F=6.391，P=0.010）、 HbA1c（F=4.536，P=0.011）、空腹血糖（ F=3.073，P=0.031）降低，其中 hsCRP显著低于对照组（ t=-2.261，P=0.028）。结论 牙周基础治疗有助于改善伴 2型糖尿病的中、重度牙周炎患者的牙周炎症和血清炎症指标以及糖代谢水平。

Effects of non-surgical periodontal treatment on clinical response,serum inammatory parameters,and metabolic control of type 2 diabetes patients with moderate to severe periodontitis

 Objective  To evaluate the effects of periodontal treatment on the clinical response, systemic inflammatory parameters, and metabolic control of type 2 diabetes patients with moderate to severe periodontitis. Methods  A total of 56 patients with mean clinical attachment level (CAL)>3 mm were included in the subgroup analysis. A repeated-measures ANOVA (group factor: treatment group and control group; time factor: initial visit, 1.5, 3, and 6 months) was used to analyze the probing depth (PD), CAL, bleeding on probing (BOP), high-sensitivity C-reactive protein(hsCRP), glycated hemoglobin (HbA1c), and fasting plasma glucose. Results Significantly lower PD (F=62.898，P=0.000), CAL (F=51.263，P=0.000), BOP (F=75.164，P=0.000), hsCRP (F=6.391, P=0.010), HbA1c(F=4.536, P=0.011), and fasting plasma glucose level (F=3.073，P=0.031) were observed after therapeutic periodontal improvement. The inter-group differences for PD (t=-2.050， P=0.045), BOP (t=-4.538，P=0.000), and hsCRP (t=-2.261, P=0.028) were statistically significant after therapy. Conclusion Non-surgical periodontaltreatmentcan effectivelyimproveperiodontalstatus,circulating inflammatory status, andmetabolic controlof diabetic patients with moderate to severe periodontitis.