糖尿病患者牙周炎治疗后血清肿瘤坏死因子α和糖化血红蛋白的变化

目的　探讨牙周基础治疗对Ⅱ型糖尿病伴牙周炎患者的影响及其影响机制。方法选择 15例Ⅱ型糖尿病伴牙周炎患者 ,于牙周基础治疗前、后的 4～ 6周分别检测其体重指数、牙龈出血指数、探诊深度、糖化血红蛋白、总胆固醇、甘油三酯和血清肿瘤坏死因子α(tumornecrosisfactor alpha ,TNF α)的水平。 结果　除体重指数和总胆固醇无显著变化外 (P >0 0 5 ) ,其余各项临床及血清学指标均显著降低 ,治疗后与治疗前相比差异有显著性 (P <0 0 5 )。其中 ,龈沟出血指数由(3 6 0± 0 5 1)降至 (1 6 7± 0 6 2 ) ,探诊深度由 (5 73± 1 16 )降至 (2 6 0± 0 83)。糖化血红蛋白由(9 78± 1 4 9) %降至 (8 4 1± 0 82 ) % ,甘油三酯由 (1 78± 0 5 2 )mmol/L降至 (1 38± 0 31)mmol/L ,TNF α由 (12 74± 3 95 )ng/L降至 (9 6 8± 2 5 2 )ng/L。 结论　对于Ⅱ型糖尿病伴牙周炎患者 ,牙周基础治疗可能通过降低患者血清TNF α的含量 ,降低其糖化血红蛋白的水平

The effect of periodontal initial therapy on circulating TNF-α and HbA1 C in type 2 diabetes patients with periodontitis

OBJECTIVE: To investigate the effect and mechanism of periodontal initial therapy on type 2 diabetes patients with periodontitis. METHODS: 15 type 2 diabetes patients with periodontitis were selected. Their body mass index (BMI), sulcus bleeding index (SBI), probing depth (PD), circulating tumor necrosis factor-alpha (TNF-alpha) concentration, and the value of glycosylated hemoglobin (HbA1C), triglycerides (TG) and cholesterol (CHOL) were assessed respectively before and 4-6 weeks after periodontal initial therapy. RESULTS: After initial therapy, SBI, PD, circulating TNF-alpha concentration, and the value of HbA1C and TG were reduced significantly (P<0.05), while there were no significant differences in BMI and CHOL value (P>0.05). CONCLUSIONS: Periodontal initial therapy can effectively reduce HbA1C value in type 2 diabetes patients with periodontitis, possibly through the reduction of circulating TNF-alpha concentration.