口腔干预对牙周炎大鼠动脉粥样硬化影响的研究

目的探讨牙周炎经不同口腔干预处理后对动脉粥样硬化的影响。方法 SD大鼠随机分为3大组,A组:正常对照组,B组:动脉粥样硬化模型组;C组:牙周炎模型组;牙周炎模型建立后,根据口腔干预措施的不同C组再随机2次分为4组,C1自然进程组、C2基础治疗组、C3服药组和C4拔牙组。各组接受相应口腔干预措施。用酶联免疫吸附(ELISA)法,检测干预前、中、后时段,血清hsCRP水平。处死动物后,光镜观察颈动脉血管壁组织的病理变化。结果自然状态无干预的各组在所有取样时间点,与A组相比,B组及C1组的hsCRP含量均显著升高(P0.05),其中,B组的hsCRP含量最高,且含量与C1组之间差异在第3次取样时间点,有统计学意义(P0.05)。进行口腔干预后,与C1组比,各干预组的hsCRP含量均有不同程度的升高,C4组的第2、3次血清hsCRP含量均显著高于C1组(P0.01),C2组在第2次取样时较C1组有下降趋势,但差异无统计学意义。颈动脉血管壁病理切片发现,除A组和C2组未见泡沫细胞形成外,其余各组均可见大量泡沫细胞的形成和聚集,出现动脉粥样硬化的早期病理改变。结论无高血脂存在的SD大鼠,单纯牙周炎任其自然发展或炎症期直接拔牙都可能增加动脉粥样硬化发生风险。牙周基础治疗可能降低动脉粥样硬化的发生风险。

Influence of oral interventions on atherosclerosis in SD rats with periodontitis

Objective To investigate the effect of oral interventions on atherosclerosis in SD rats with periodontitis. Methods SD rats were randomly divided into three groups： control group （group A）, atherosclerosis group （group B） and periodo.ntitis group（ group C）. Group G was further divided into natural process group （ C1 ）, sealing and root planning group （ C2）, systemic antibiotics group （ C3 ） and tooth extraction group （CA）. Every group received the oral interventions. Serum hsCRC levels were determined before oral interventions and 1 week after interventions by ELISA. All animals were scarificed after 14 weeks, and the carotid artery plaque was examined by pathology. Results The levels of serum hsCRC in group B and C1 were both significantly higher than that of group A （ P 〈 0. 05 ）. The serum hsCRP level of group B was the highest among the three groups, which was significantly higher than that of group C1 （P 〈0. 05）. After oral interventions, the hsCRP levels of group C2, C3 and CA were significantly elevated compared with group C1, and the level of group CA was significantly higher than that of group C1 （P 〈 0. 01 ）. The serum hsCRP level of group C2 became lower than that of group C1 after the second oral intervention. Numerous foam cells were infiltrated in group B, C1, C3 and CA, while no foam cells were found in group C2. Conclusion Either tooth extraction or periodontitis could increase the risk of atherosclerosis in SD rats. Periodontal therapy might reduce the risk of atherosclerosis in systemically healthy rats with periodontitis.