2型糖尿病合并牙周炎患者血清淀粉样蛋白A变化及其临床意义

目的：观察2型糖尿病合并牙周炎患者血清淀粉样蛋白A（ SAA）变化，探讨其临床意义。方法选择本院2012年6月—2013年9月门诊及住院初诊2型糖尿病患者82例，分为单纯糖尿病组（39例）和糖尿病合并牙周炎组（43例），同时选择30例健康人作为对照组。记录3组龈沟出血指数（ SBI）和探诊深度（ PD），采用酶联免疫法测定法检测各组血清 SAA 水平，同时测定各组空腹血糖（ FBG ）、空腹胰岛素（ Fins ）、胰岛素抵抗指数（HOMA-IR）、白素介6（IL-6）、肿瘤坏死因子α（TNF-α）等，并分析SAA与各指标的相关性。结果单纯糖尿病组和糖尿病合并牙周炎组血清SAA水平高于对照组，糖尿病合并牙周炎组血清SAA水平高于单纯糖尿病组，差异均有统计学意义（ P〈0.05）。血清SAA水平与FBG、TNF-α、IL-6、SBI、Fins、PD和HOMA-IR成正相关（ P〈0.05）。结论2型糖尿病合并牙周炎患者血清SAA水平与炎性反应及胰岛素抵抗密切相关，是反映牙周破坏程度的敏感指标，可成为判断牙周炎严重程度的参考指标。

Changes and Clinical Significance of Serum Amyloid A Protein Level in Patients with Type 2 Diabetes Melitus and Peri-odontitis

Objective To investigate the changes and clinical significance of serum amyloid A protein（ SAA） level in patients with type 2 diabetes melitus（T2DM）and periodontitis. Methods From June 2012 to September 2013,82 newly diagnosed T2DM patients in our hospital were selected and divided into simple T2DM group（39 cases） and T2DM combined with periodontitis group （ 43 cases ）, and meanwhile 30 healthy cases were selected as control group. Sulcus bleeding index （SBI）and probing depth（PD）were recorded. Serum SAA level was detected by Enzyme-linked immunoassay assay,and fasting blood glucose（FBG）,fasting insulin（Fins）,HOMA-IR,interleukin-6（IL-6）and tumor necrosis factor-α（ TNF-α） were measured. The correlation of serum SAA level with other index was analyzed. Results Serum SAA level of simple T2DM group and T2DM combined with periodontitis groups were higher than that of control group,and that of T2DM com-bined with periodontitis group was higher than that of simple T2DM group,the differences were statistically significant（ P〈0. 05）. Serum SAA level was positively correlated with FBG,TNF -α,IL -6,SBI,Fins,PD and HOMA - IR（ P 〈0. 05）. Conclusion Serum SAA level is closely related to inflammatory reactions and insulin resistance,is an sensitive index for reflecting periodontal destructiveness,may be an reference of periodontitis.