冠状动脉粥样硬化性心脏病与牙周病的相关性

目的探讨冠状动脉粥样硬化性心脏病(CAD)与牙周病的关系。方法比较45例CAD患者和40例对照组的牙周组织病变程度。采用高敏C反应蛋白(hsCRP)、白介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)反映冠状动脉的损伤程度,采用牙龈指数(GI)、菌斑指数(PI)和牙周病指数(PDI)评估牙龈的炎症程度。结果CAD组的hsCRP(5·75±1·26)mg/L、IL-1β(10·32±2·96)ng/L和TNF-α(9·17±2·14)ng/L均显著高于对照组的(1·13±0·73)mg/L、(2·87±1·45)ng/L和(5·84±1·96)ng/L(P<0·01)。CAD组牙周病患病率(84·44%)显著高于对照组(22·50%)(P<0·01)。CAD组的GI及PI显著高于对照组(P<0·01),而且CAD组的PDI(2·12±0·58)显著高于对照组(0·79±0·42)(P<0·01)。多因素分析显示,除脉压差和低密度脂蛋白胆固醇外,PDI也是导致CAD的高危因素,其相对危险度为1·217(95%CI1·120~1·805,P<0·05)。结论牙周病能够引起CAD,强调公众口腔卫生对防治CAD具有重要意义。

Correlation between periodontal disease and coronary atherosclerotic heart disease

OBJECTIVE: To investigate the correlation between coronary atherosclerotic heart disease (CAD) and periodontal disease (PD). METHOD: Forty-five patients with CAD (CAD group) and 40 patients without CAD (control group) were compared with their pathological changes of periodontal tissues and inflammatory markers [high sensitive C reactive protein (hsCRP), interleukin-1beta (IL-1beta), and tumor necrosis factor-alpha (TNF-alpha)]. RESULTS: Univariate analysis showed that the prevalence of PD was 84.44% in CAD group and 22.50% in control group (P < 0.01). The levels of hsCRP, IL-1beta, and TNF-alpha were (5.75 +/- 1.26) mg/L, (10.32 +/- 2.96) ng/L, and (9.17 +/- 2.14) ng/L in CAD group and (1.13 +/- 0.73) mg/ L, (2.87 +/- 1.45) ng/L, and (5.84 +/- 1.96) ng/L in control group (P < 0.01). Gingival index and plaque index were statistically different between two both groups (P < 0.01). Logistic regression analysis showed that in addition to pulse pressure and low density lipoprotein cholesterol, periodontal disease index was a higher risk factor of CAD. Its relative risk was 1.217 (95% CI was 1.120-1.805, P < 0.05). CONCLUSION: PD can cause CAD. The improvement of public oral health plays an important role in the prevention and treatment of CAD.