孕妇牙周病中牙龈卟啉单胞菌和血清炎性因子与早产低体重儿的关系

目的探讨孕妇牙周病中牙龈卟啉单胞菌（P.gingivalis）检出情况、血清炎性因子与早产低体重（PLBW）的关系。方法通过严格筛查分别选取分娩出早产低体重儿的产妇（PLBW组）和正常分娩的产妇各30例（对照组），对其牙周状况进行检查，记录菌斑指数（PI）、出血指数（BI）、探诊深度（PD）及临床附着丧失水平（CAL），并采集产妇龈下菌斑、静脉血和脐带血，采用16S rRNA PCR法检测菌斑中P.gingivalis，酶联免疫吸附试验（ELISA）检测血清中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和前列腺素E2 （ PGE2）水平。结果PLBW组牙周状况较差，P.gingivalis在PLBW组和对照组中检出率分别为56.7%和30.0%，两者差异有统计学意义（P<0.05）。牙周病变程度、P.gingivalis检出率与胎儿孕周和出生体重均呈弱负相关（P<0.05）。PLBW组静脉血和脐带血中IL-1β、IL-6、PGE2水平均较对照组高；PLBW组内患有牙周病者静脉血中IL-1β、PGE2含量高于牙周健康者（P<0.01）。结论孕妇牙周感染可能是导致早产低体重儿的原因之一。

Study on maternal periodontal diseases of the relationships between Porphyromonas gingivalis,serum pro-immflamatory mediators and preterm low birth weight

Objective To investigate the associations between periodontal diseases,presence of Porphyromonas gingivalis (P.gingivalis),serum levels of pro-inflammatory mediators and pretenn low birth weight(PLBW).Methods 60 women(30 PLBW and 30 healthy women),were recruited after postpartum within 3 days in this case-control study.Periodontal measurements including plaque index(PI),bleeding index(BI),probing pocket depth(PD)and clinical attachment loss(CAL)were assessed.The subgingival plaque was collected before periodontal examination and analysed by polymerase chain reaction(PCR)for the presence of the 16S rRNA gene specific to P.gingivalis,while the venous and umbilical cord blood specimens collected were determined by enzyme-linked immunosorbent assay(ELISA).Results The PLBW cases had a poorer oral conditions and the presence of P.gingivalis was found in a higher proportion in the PLBW than the healthy pregnant(56.7% vs.30.0%,P<0.05).Both of the presence of periodontitis and P.gingivalis have been found to be associated weakly with a shorter gestational age and a lower birth weight(P<0.05).The levels of IL-1β,IL-6 and prostaglandin-E_2(PGE_2)in both of the blood samples showed higer levels between the PLBW and normal groups(P<0.01).The IL-1β and PGE_2 levels in maternal serum were higher with a severe periodontal disease in the PLBW group(P<0.01).Conclusion There may be a possible link between periodontal diseases and PLBW.