2型糖尿病患者牙周病与糖尿病肾病的相关性分析

目的：分析2型糖尿病患者牙周病与糖尿病肾病发生发展的相关性。方法：2型糖尿病患者120例,依据24 h尿微量白蛋白（MAU）定量进行分组：MAU〈30 mg/24 h为正常蛋白尿组（DN0组）;MAU 30-300 mg/24 h为糖尿病早期肾病组（DN1组）;MAU〉300 mg/24 h为糖尿病临床肾病组（DN2组）。对患者进行牙周检查,检查项目包括：出血指数（BI）、牙周探诊深度（PD）、临床附着丧失（CAL）及缺牙数目。入院常规检验患者的血尿素氮（BUN）、血肌酐（SCr）,并采集患者基线资料：病程、吸烟情况及牙周疾病治疗史,测量血压。结果：（1）DN1组与DN0组相比,BI、PD、CAL及缺牙数目均升高（P〈0.01）,DN2组与DN1组相比,BI、PD、CAL及缺牙数目均升高（P〈0.01）。（2）Logistic回归分析显示,PD、CAL及缺牙数目是糖尿病肾病发生发展的独立危险因素（P〈0.05）。（3）BUN、SCr与BI、PD、CAL及缺牙数目均呈正相关（rBUN=0.153、0.148、0.273、0.336,P〈0.05;rSCr=0.189、0.276、0.326、0.268,P〈0.01）。结论：2型糖尿病患者牙周病与糖尿病肾病关系密切,牙周及牙齿缺失状况可以预示糖尿病肾病的发生发展。

Correlation between diabetic nephropathy and periodontal disease

Objective： To explore the relationship between diabetic nephropathy（DN） and periodontal disease. Methods： A hundred and twenty hospitalized patients with type 2 diabetes were enrolled. Subjects were further divided into three groups according to their levels of microalbuminuria（MAU）： normal albuminuria group（group DN0）： MAU30 mg/24 h, early stage DN group（group DN1）： MAU 30-300 mg/24 h, clinical DN group（group DN2）： MAU300 mg/24 h. The periodontal conditions including the periodontal pocket depth（PD）, bleeding index（BI）,clinical attachment loss（CAL） and tooth loss were detected. The clinical data and kidney function markers including serum creatinine（SCr）, blood urea nitrogen（BUN） were collected and blood pressure were measured. Results：（1） compared with DN0 group, BI,PD,CAL and tooth loss for DN1 group were increasing（P〈0.01）. Compared with DN1 group, BI,PD,CAL and tooth loss for DN2 group were increasing（P〈0.001）.（2）Logistic analysis showed that PD,CAL and tooth loss were independent risk factors of DN（P〈0.05）.（3） SCr and BUN were positively correlated with BI,PD,CAL and tooth loss（rBUN=0.153, 0.148, 0.273, 0.336, P〈0.05;rSCr=0.189, 0.276,0.326,0.268, P〈0.01）.Conclusion： Type 2 diabetes in patients with periodontal disease are closely related to diabetic nephropathy. Periodontal desease and teeth condition can indicate the occurrence and development of diabetic nephropathy.