米诺环素联合康复新液对慢性牙周炎疗效及血清PD-1、PD-L1表达的影响

［摘要］ 目的 探讨米诺环素联合康复新液对慢性牙周炎疗效及血清程序性细胞死亡1（programmed death-1，PD-1）、程序性细胞死亡配体1（programmed death-ligand 1，PD-L1）表达的影响。 方法 192例牙周炎患者，随机数字表法分为2组各96例，观察组采用米诺环素联合康复新液治疗，对照组采用米诺环素治疗，观察2组临床疗效和总有效率，比较组2组菌斑、牙周探诊深度、牙龈出血指数；比较2组治疗前后血清炎症因子变化；比较2组治疗前后血清PD-1和PD-L1水平变化和不良反应。 结果 观察组临床疗效和总有效率均高于对照组（P＜0.05）；观察组菌斑指数、牙周探诊深度、牙龈出血指数均低于对照组（P＜0.05）；治疗后2组血清因子干扰素γ（interferon-γ，IFN-γ）、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、白细胞介素8（interleukin-8，IL-8）和超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）均较治疗前明显降低（P＜0.05），IL-10均较治疗前明显升高（P＜0.05），观察组降低和升高幅度较大，治疗后观察组血清因子IFN-γ、TNF-α、IL-8和hs-CRP低于对照组，（P＜0.05），2组不良反应发生率差异无统计学意义（P＞0.05）。 结论 米诺环素联合康复新液可有效降低慢性牙周炎患者血清CD4+、CD8+T淋巴细胞上PD-1和PD-L1表达，缓解炎症反应，改善临床症状，提高治疗效果。

Clinical efficacy on Kangfuxin Liquid combined with Minocycline in treatment of chronic periodontitis and its effect on expression of PD-1 and PD-LI

［Abstract］ Objective To explore the clinical efficacy on Kangfuxin liquid combined with Minocycline in treatment of chronic periodontitis and its effect on expression of programmed death-1（PD-1） and programmed death-ligand 1（PD-L1）. Methods One hundred and ninety-two patients with periodontitis were randomly divided into two groups, 96 cases in each group. the observation group was treated with Minocycline combined with Kangxinxin liquid, the control group was treated with Minocycline. The clinical efficacy and total effective rate of the two groups were observed. The plaque, periodontal probing depth and gingival bleeding index of the two groups were compared. The changes of serum inflammatory factors before and after treatment were compared. The serum PD-1 and PD-L1, level changes and adverse reactions before and after treatment were compared. Results The clinical efficacy and total effective rate of the observation group were higher than those of the control group(P＜0.05). The plaque index, periodontal probing depth and gingival bleeding index of the observation group were lower than the control group(P＜0.05). After treatment, the serum levels of interferon-γ（IFN-γ）, tumor necrosis factor-α（TNF-α）, interleukin-8（IL-8） and hypersensitive C-reactive protein（hs-CRP） were significantly lower than those before treatment(P＜0.05), and IL-10 was significantly higher than that before treatment(P＜0.05). The observation group decreased and increased greatly. The serum levels of IFN-γ, TNF-α, IL-8 and hs-CRP in the observation group were lower than those in the control group(P＜0.05). There was no significant difference in the incidence of adverse reactions between two groups(P＞0.05). Conclusion Minocycline combined with Kangxinxin can effectively reduce the expression of PD-1 and PD-L1 on CD4+ and CD8+ T lymphocytes in patients with chronic periodontitis, relieve inflammation, improve clinical symptoms, and improve treatment efficacy.