本文選題：高原地區(qū)　切入點(diǎn)：牙周病　出處：《青海大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:了解高原地區(qū)輕度認(rèn)知障礙(Mild Cognitive Impairment,MCI)和阿爾茨海默病(Alzheimer's disease,AD)與重度牙周病的相關(guān)性;探討低氧環(huán)境下口腔慢性感染是否為MCI和AD的危險(xiǎn)因素及其潛在機(jī)制。方法:收集2015年12月到2017年02月在青海省人民醫(yī)院(海拔2,260m)老年病研究所和口腔科門診的漢族重度牙周病患者和健康人群271例,給予認(rèn)知量表篩查和牙周臨床指標(biāo)檢查,按牙周病和認(rèn)知障礙程度分成4組:正常對照組、重度牙周病組、重度牙周病+MCI組、重度牙周病+AD組。測定研究對象血清生化指標(biāo)和牙周臨床指標(biāo)。采用ELISA方法測定血清、齦溝液IL-1β、IL-6的濃度,熒光定量PCR方法檢測齦下菌斑中牙齦卟啉單胞菌(Pg)的檢出率,所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.四組研究對象的性別、年齡和文化程度無顯著差異(p0.05),四組在MMSE、Mo CA、ADAS-Cog認(rèn)知量表評分比較差異有統(tǒng)計(jì)學(xué)意義(p0.05)。2.隨著認(rèn)知程度的加重,血清HCY呈上升趨勢,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。重度牙周病+AD組LDL-C較正常對照組升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05);3.與對照組比較,隨著牙周炎與認(rèn)知的加重,三組牙周袋探診深度(PD)、臨床附著水平(CAL)和出血指數(shù)(BI)呈線性遞增,重度牙周病+AD組增高顯著。四組齦下菌斑中Pg總的檢出率為65.68%,健康對照組為37.38%,重度牙周病組71.21%,重度牙周病+MCI組76.19%,重度牙周病+AD組94.23%,四組比較,差異有統(tǒng)計(jì)學(xué)意義(p0.05);4.與對照組比較,重度牙周病+AD組、重度牙周病+MCI組和重度牙周病組血清和齦溝液IL-1β、IL-6升高,差異有統(tǒng)計(jì)學(xué)意義(p0.05),重度牙周病+AD組與重度牙周病+MCI組IL-6明顯高于重度牙周病組(p0.05)。同一炎癥因子,在齦溝液的濃度較血清濃度高,差異有統(tǒng)計(jì)學(xué)意義(p0.05);5.對牙周臨床指標(biāo)、神經(jīng)量表和IL-1β、IL-6進(jìn)行相關(guān)分析,結(jié)果發(fā)現(xiàn),PD、CAL與MMSE、Mo CA、CDT呈負(fù)相關(guān)(p0.01),PD、CAL與ADAS-Cog呈正相關(guān)(p0.01),PD、CAL與血清和齦溝液IL-1β、IL-6均呈正相關(guān)。結(jié)論:1.高HCY和LDL-C血癥可能加重認(rèn)知功能損害;2.高原地區(qū)重度牙周病合并MCI和AD患者Pg檢出率高,兩組血清和齦溝液IL-1β、IL-6明顯高于正常組和重度牙周病組;3.低氧環(huán)境下重度牙周病和認(rèn)知功能可能存在相互作用。
[Abstract]:Objective: To investigate the mild cognitive impairment in plateau area (Mild Cognitive Impairment, MCI) and Alzheimer's disease (Alzheimer's disease, AD) associated with severe periodontal disease; to investigate the effect of hypoxia environment oral chronic infection are risk factors for MCI and AD and its potential mechanism. Methods: from December 2015 to 2017 02 in Qinghai People's Hospital (altitude 2260m) Institute of geriatrics and outpatient department of Stomatology Han severe periodontal disease patients and 271 healthy people, given the cognitive scale screening and clinical indicators of periodontal examination, divided into 4 groups according to the periodontal disease and cognitive impairment: normal control group, severe periodontal disease group, severe periodontal disease group +MCI, severe tooth week +AD disease group. To determine the object of study of serum biochemical indexes and periodontal clinical parameters. The determination of serum by ELISA method, GCF IL-1 beta, IL-6 concentration, fluorescence quantitative PCR method for detecting the gums in subgingival plaque Gingivalis (Pg) detection rate, the data were statistically analyzed. Results: 1. of the four groups had no significant difference in gender, age and education level (P0.05), four in MMSE group, Mo CA, there were significant differences between the ADAS-Cog cognitive scale score (P0.05).2. with increasing cognitive degree the serum HCY increased, the difference was statistically significant (P0.05). Severe periodontal disease group +AD LDL-C increased compared to normal control group, the difference was statistically significant (P0.05; 3.) compared with the control group, with severe periodontitis and cognition, three groups of periodontal probing depth (PD), clinical attachment level (CAL) and bleeding index (BI) is a linear increase of severe periodontal disease in +AD group increased significantly. The four groups in the subgingival plaque Pg total detection rate was 65.68%, control group was 37.38%, severe periodontal disease group 71.21%, severe periodontal disease in 76.19% of +MCI group, severe periodontal disease +AD group 94.23%, four groups, 宸紓鏈夌粺璁″鎰忎箟(p0.05);4.涓庡鐓х粍姣旇緝,閲嶅害鐗欏懆鐥，

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