冠状动脉粥样硬化斑块与牙周致病菌的关系

目的 检测冠状动脉粥样硬化斑块中是否存在牙周致病菌,并比较同一患者动脉粥样硬化斑块及其龈下菌斑中的牙周致病菌的一致性,以探讨冠心病和牙周病之间可能的关系.方法 选择51例行冠状动脉搭桥术的患者,术前及术后分别收集龈下菌斑和冠状动脉粥样硬化斑块,采用牙周致病菌特异性引物,通过聚合酶链反应(PCR)技术,检测粥样硬化斑块及龈下菌斑中牙周致病菌的DNA并对扩增产物进行测序分析.结果 51例冠状动脉粥样硬化斑块中,牙龈卟啉单胞菌(P.g)的阳性率33%(17例),福赛类杆菌(T.f)的阳性率31%(16例),中问普氏菌(P.i)的阳性率18%(9例),具核梭杆菌(F.n)的阳性率12%(6例),未检测出伴放线放线杆菌(A.a).51例龈下菌斑中,T.f阳性率84%(43例),F.n阳性率78%(40例),P.i阳性率59%(30例),P.g阳性率39%(20例),A.a阳性率22%(11例);32例患者同时在动脉粥样硬化斑块及龈下菌斑中检测出牙周致病菌.结论 冠状动脉粥样硬化斑块中存在牙周致病菌,牙周致病菌在冠状动脉粥样硬化发生、发展过程中起一定的作用,可能和冠心病发病相关.

Detection of periodontal pathogenic bacteria DNA in coronary atheromatous plaques from patients underwent coronary artery bypass graft

Objective The aim of this study was to observe the coexistence of periodontal bacteria DNA(Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum,Porphyromonas gingivalis,Prevotella intermedia,Tannerella forsythensis)in coronary atheromatous plaques and subgingival plaques in patients scheduled for coronary artery bypass graft.Methods Coronary atheromatous plaque and subgingival plaque samples were obtained from 51 patients and examined by polymerase chain reaction (PCR)technique with specific primers for periodontal bacteria.Results P.gingivalis(33%),T.forsythensis(31%),P.intermedia(18%) and F.nucleatum (12%) were detected while A.aetinomycetemcomitans was negative and not found in coronary atheromatous plaques;T.forsythensis (84%),F.nucleatum(78%),P.intermedia(59%),P.gingivalis(39%) and A.actinomycetemcomitans (22%) were detected in subgingival plaque samples.Coexistence of periodontal bacteria DNA in coronary atheromatous and subgingival plaque samples was evidenced in 32 patients.Conclusions The coexistence of T.forsythensis,F.nucleatum,P.intermedia,P.gingivalis in coronary atheromatous plaques and the subgingival plaque samples in CAD patients could suggest a potential role for periodontal pathogenic bacteria in atherosclerosis disease process.