吸烟对牙周基础治疗前后龈沟液量和弹性蛋白酶水平的影响

目的　评价吸烟是否影响牙周炎基础治疗前、后龈沟液 (gingivalcrevicularfluid ,GCF)量和龈沟液中弹性蛋白酶 (elastase ,EA)的水平。方法　将 37例男性慢性牙周炎患者分为吸烟组 (2 2例 ,12 2个牙位点 ,每日吸烟≥ 2 0支 )和非吸烟组 (15例 ,90个牙位点 )。牙周炎基础治疗前、后用滤纸条法收集GCF ,用Periotron 6 0 0 0龈沟液测量仪测定GCF量。对吸烟组 92个位点和非吸烟组 6 0个位点GCF样本 ,用底物分解法检测EA水平。结果　治疗前吸烟组GCF量 (139 2± 33 4 )U和EA水平(0 6 34± 0 5 87)明显低于非吸烟组 GCF量 :(15 5 4± 39 7)U ,EA水平 :0 835± 0 5 72 ],P <0 0 1。治疗后 ,两组GCF量和EA水平均显著降低 (P <0 0 0 1)。但吸烟组 91个位点 (74 6 % )GCF和 70个位点(76 1% )的EA水平治疗后有改善 ;而非吸烟组高达 88个位点 (97 8% )GCF和 5 6个位点 (93 3% )的EA水平有改善 (P <0 0 1)。结论　治疗前探诊深度相同的情况下 ,吸烟组GCF量和EA水平均低于非吸烟组 ,治疗后吸烟组的GCF和EA的减少程度不如非吸烟组明显。

The effects of smoking on gingival crevicular fluid volume and elastase before and after initial periodontal treatment

OBJECTIVE: To investigate the relationship between smoking and gingival crevicular fluid volume (GCF), level of elastase (EA) in 37 severe periodontitis patients before and after 1 month periodontal initial treatment. METHODS: The GCF samples were collected from 122 sites in 22 heavy smokers (>or= 20 cigarettes/day) and 90 sites in 15 non-smokers before and after 1 month periodontal initial treatment. There is no difference (P > 0.05) on pocket depth between smoking sites (5.6 +/- 1.2) mm and non-smoking sites (5.4 +/- 1.2) mm at baseline. The volume of each GCF sample was measured by Periotron 6000 and the elastase in GCF were determined by substrate (meosuc-als-als-pro-val-NA) method. RESULTS: After non-surgical treatment both GCF volume and elastase level were significantly decreased (P < 0.001) in both smokers and non-smokers. But the decrease of GCF volume (91 sites, 74.6%) and elastase level (70 sites, 76.1%) in smokers were significant lower (P < 0.01) than non-smokers (GCF, 88 sites, 97.8%; EA, 56 sites, 93.3%). CONCLUSION: These findings suggest that smoking has effect on gingival crevicular fluid volume and elastase level of patients with periodontitis.