伴2型糖尿病的慢性牙周炎牙周可疑致病菌的检测

目的 检测伴2型糖尿病(diabetes mellitus,DM)的慢性牙周炎(chronic periodontitis,CP)患者龈下菌斑中牙周可疑致病菌的种类和构成,从微生物学角度探讨牙周炎与DM的相互作用机制.方法 采集伴2型DM的CP患者154例(DM组)、不伴DM的单纯CP患者120例(CP组)及40名全身及牙周健康者(N组)的龈下集合菌斑,传统酚-氯仿法提取菌斑DNA,以牙龈卟啉单胞菌(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),福塞坦氏菌(Tannerella forsythia,Tf),齿垢密螺旋体(Treponema denticola,Td)为目标菌,应用以16SrRNA为基础的聚合酶链反应(PCR)技术对龈下菌群进行检测.结果 Pg、Aa、Fn、Pi、Tf、Td在DM组中均可检出;与CP组相比,在性别、年龄、牙周状况基本一致的情况下,轻度牙周炎者DM组Pi的检出率为35%(8/23),CP组为65%(13/20),两组间差异有统计学意义(P<0.05);重度牙周炎者DM组Pg、Aa、Tf的检出率分别为78%(72/92)、27%(25/92)、67%(62/92),CP组分别为58%(35/60)、17%(10/60)、43%(26/60),DM组均显著高于CP组,差异有统计学意义(P<0.05).同时,DM组Aa、Tf PCR产物的平均灰度值(average gradation,AVG)比值显著高于CP组,Pi的AVG比值明显低于CP组,P<0.05.结论 与单纯CP相比,伴2型DM的牙周炎患者龈下菌斑中Pg、Aa、Tf的数量增多,Pi的数量减少.

Detection of putative periodontal pathogens of periodontitis with type 2 diabetes

Objective To detect the putative periodontal pathogens in the subgingival plaque of chronic periodontitis ( CP) patients with type 2 diabetes mellitus ( DM) and to discuss the role of the periodontal pathogens in the CP and type 2 DM patients. Methods The study included 154 CP patients with type 2 DM ( DM graup), one hundred and twenty subjects with CP (CP group) and 40 healthy subjects. Subgingival plaque samples were obtained with sterile subgingival curettes and pathogens genomic DNA were extracted by phenol and chloroform from plaque. Taking Porphyromonas gingivalis ( Pg) , Actinobacillus actinomycetemcomitans ( Aa ) , Fusobacterium nucleatum ( Fn) , Prevotella intermedia ( Pi) , Tannerella forsythia(Tf) and Treponema denticola(Td) as aim pathogens, polymerase chain reaction (PCR) method was used to determine the prevalence of Pg, Aa,Fn,Pi,Tf and Td in the subgingival plaque samples.Results Pg, Aa, Fn, Pi, Tf and Td were all found in the subgingival plaque of DM group. In serious periodontitis, the detection rate of Pg, Aa and Tf in DM group Pg:78% (72/92) , Aa:27% (25/92) ,Tf: 67% (62/92) ] was significantly higher than in the CP group Pg:58% (35/60) , Aa: 17% ( 10/60) ,Tf: 43% (26/60) ] ,P <0. 05. In slight periodontitis, the detection rate of Pi in DM group was significantly lower than in the CP group. At the same time, the average gradation(AVG) ratio of PCR product of Aa and Tf in DM group was significantly higher than in the CP group and the AVG ratio of Pi in DM group was significantly lower than in the CP group ( P < 0. 05 ). Conclusions Compared with the pure CP, the quantity of Pg, Aa and Tf in the subgingival plaque of the periodontitis patients with type 2 DM increased, but the Pi quantity reduced.