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目的通过观察血清超敏C反应蛋白(high-sensitivity C-reactive protein,hsCRP)水平的变化探讨牙周基础治疗对伴或不伴高脂血症的慢性牙周炎(chronic periodontitis,CP)大鼠动脉粥样硬化(atherosclerosis,As)发生的影响。方法本研究于2011年5—9月在山西医科大学口腔医学院完成。将24只6周龄雄性SD大鼠随机分为4组,即正常对照组(A组)、高脂血症组(B组)、CP组(C组)和高脂血症+CP组(D组),每组6只。各组接受相应的建模及牙周干预处理,同时定期进行牙周临床检查,酶联免疫吸附(ELISA)法检测牙周干预前及每次干预后1周(共2次)3个取样时间点的血清hsCRP水平。结果牙周临床检查结果显示,整个实验过程中A、B组大鼠实验牙牙龈未见炎症性改变;C、D组大鼠建模后实验牙牙龈炎症明显,有深牙周袋,部分实验牙松动度达Ⅱ~Ⅲ度,基础治疗后炎症明显减轻,牙齿均无松动。同一时间点上,B、C及D组大鼠血清hsCRP水平均显著高于A组,差异有统计学意义(P<0.01)。在不同时间点上,B、C及D组大鼠治疗后血清hsCRP水平均较治疗前显著增高,差异有统计学意义(P<0.01)。其中,C组大鼠2次治疗后血清hsCRP水平趋于稳定,D组大鼠在2次治疗后1周血清hsCRP水平显著增高。结论对于慢性牙周炎大鼠,无高脂血症情况存在时,牙周基础治疗可能会在短期内增高As的发生风险;在存在高脂血症状态下,直接牙周基础治疗可能会在较长时间内增高As的发生风险。

Effects of periodontal basic therapy on atherosclerosis in chronic periodontitis rats with or without hyperlipidemia Sill

Objective To study serum hsCRP levels in the rat model of chronic periodontitis（CP） with or without hyperlipidemia after periodontal basic therapy and the effect on the the risk of atherosclerosis. Methods SD rats were randomly divided into four groups： control group （group A）, hyperlipidemia group （group B）, periodontal treatment for periodontitis group （group C）, and periodontal treatment for periodontitis with hyperlipemia group （group D） ; every group received the corresponding treatment and periodontal examination. Serum hsCRP levels were assayed by ELISA before and after every periodontal basic therapy 1 week. Results Periodontal clinical parameters revealed no inflammatory changes of the experimental gingiva in group A and B were found during the whole process. There were obvious inflammatory reaction of the gingiva, deep periodontal pocket, and loosening of the teeth in the other 2 groups after establishment of CP animal model;however, after periodontal basic therapy the experimental gingival inflammation was improved obviously in group C and D. The serum hsCRP levels of group B, C and D were significantly higher than those of group A at the same time （P 〈 0.01 ）. At different times, after periodontal basic therapy the serum hsCRP levels of group B, C and I） were significantly higher than before （P 〈 0.01 ）, and the serum hsCRP level of group C was stable after periodontal basic＇ therapy , but after twice of periodontal basic therapy the one-week serum hsCRP level of group D increased gradually. Conclusion Our pilot intervention trial has indicated that periodontal basic therapy （scaling and root planning） may raise the risk of atherosclerosis in systemically healthy rats with periodontitis in a short time, but direct periodontal basic therapy may raise the risk of periodontitis associated with systemically cardiovascular diseases for a fairly long time.