牙周基础治疗对伴中重度牙周炎冠心病患者牙周状况及血清炎性因子的影响

目的探讨冠心病伴中、重度牙周炎患者牙周基础治疗后，牙周状况及血清白介素-1β（IL-1β）和肿瘤坏死因子-α（TNF-α）水平的变化。方法选择100名伴有中、重度牙周炎的冠心病患者，随机分为两组，研究组50例患者在心内科治疗基础上行牙周基础治疗，对照组50例患者仅行心内科治疗。观察各组治疗前、治疗8周后的牙周临床指标（龈沟出血指数、探诊深度、临床附着丧失）和血清IL-1β、TNF-α水平。结果牙周基础治疗后，研究组的各项牙周临床指标均有好转，血清中IL-1β及TNF-α水平明显降低，差异有统计学意义（P〈0．01）。研究者与对照组相比，治疗前的各项指标差异无统计学意义，治疗8周后，研究组的牙周临床指标和血清IL-1β、TNF-α水平与对照组相比均有明显差异，有统计学意义（P〈0．01）。结论牙周基础治疗不仅能改善牙周状况，还可降低血清IL-1β和TNF-α和水平，有利于冠心病的预防和治疗。

Effects of periodontal therapy on serum IL-1βand TNF-αlevels in patients of coronary heart disease with chronic periodontitis

Objective To assess whether periodontal therapy may produce a periodontal improvement along with a change on serum IL-1β and TNF-α levels in patients of coronary heart disease with chronic periodontitis. Methods 100 coronary heart disease patients with periodontitis were recruited and divided into two groups randomly. Study group were treated with the routine medicine maintenance therapy and periodontal therapy, while control group treated with the routine therapy alone. Plaque index（PLI）, sulcus Needing index（SBI）, pocket depth（PD）, clinical attachment loss（CAL） and serum IL-1β and TNF-α devels were tested before and 8 weeks after periodontal therapy, respectively. Results 8 weeks after periodontal therapy, all patients in study group demonstrated significant improvement of clinical periodontal status, including PLI, SBI, PD, CAL. The levels of IL-1β and TNF-α decreased significantly. Obvious differences were found between the clinical periodontal status of study and control group, and greater improvement of inflammation situation was found in study group. Conclusion This study demonstrates that periodontal therapy can not only improve clinical periodontal status but also decrease the serum markers levels, such as IL-1β and TNF-α. This can play a positive role in the prevention and therapy of CHD.