本文選題：牙周病 + 冠心病��； 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 冠狀動脈粥樣硬化心臟病(AS,又可以稱為冠心病,coronary heart disease, CHD)目前已可以說是首要影響人們身體健康和生存質(zhì)量的疾病之一。慢性的牙周炎(CP)是一些細菌微生物潛伏在人口腔的牙周組織的周圍,通過長時間不斷地侵害和損傷,從而導(dǎo)致人體牙周組織的局部感染,造成牙周局部組織結(jié)構(gòu)、功能的損傷,還可能會引發(fā)機體全身各個系統(tǒng)(如心血管系統(tǒng))的損害。大量的研究成果都表現(xiàn)出慢性牙周病與冠心病之間的潛在聯(lián)系,像吸煙,高血壓,糖尿病,肥胖,血脂等都可以作為相近的影響因素,促進和增加兩種疾病的患病率。牙周炎與冠心病其疾病的病理本質(zhì)即為機體相應(yīng)組織的炎癥性感染,疾病的整體過程即為一場炎癥反應(yīng),而C-反應(yīng)蛋白(C-reactive protein, CRP)則是在炎癥反應(yīng)中是極其活躍而敏感的物質(zhì)之一,他可能與兩種疾病都存在密切地相關(guān)性。本課題通過研究CRP在血清中的分布,及其與血清學(xué)和牙周各指標(biāo)的關(guān)系,探討CRP與這兩種疾病存在的某種相關(guān)性,和其在整個疾病病程中所起到的關(guān)鍵性作用。 方法 1.研究目標(biāo) 選取2013.9月至2013.12月于山西省心血管醫(yī)院心內(nèi)科住院的首次確診為冠心病的患者60例,其中冠心病伴牙周炎組(CP組)30例,單純冠心病組(C組)30例,從省人民醫(yī)院口內(nèi)門診和體檢中心選擇單純慢性牙周炎患者30例,健康志愿者30例,分別為牙周炎組(P組),健康對照組(H組) 2.臨床資料收集 2.1.一般常規(guī)性檢查 對所有受試者均詳細記錄其年齡、性別、身高、體重、吸煙史、既往高血壓史及全身系統(tǒng)病史等項目。所有入選者均接受血液生化檢測,抽取清晨空腹靜脈血,檢測并將相關(guān)數(shù)據(jù)結(jié)果登記注冊在案。具體登記結(jié)果包括：血清中的高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、總膽固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)和白細胞數(shù)(WBC)。 2.2.口腔�？茩z查 每一個受試者的口腔牙周系統(tǒng)組織進行詳細全面的檢查,測量代表牙的六個牙位點(即舌腭側(cè)牙面的近中點、中間點和遠中點,唇頰側(cè)牙面的近中點、中間點和遠中點),測得每個代表牙的牙周探診深度(PD),齦溝出血指數(shù)(SBI),附著喪失(AL),分別將相應(yīng)指標(biāo)登記在案。 2.3.血清CRP檢測 對所有受試者進行抽血化驗,取早晨的空腹靜脈血,選用免疫比濁法檢測血清hs-CRP,并登記結(jié)果。 結(jié)果： 1.常規(guī)臨床指標(biāo)結(jié)果： 四組間性別、HDL、FPG間無明顯差異(P0.05)。所有患者組血清白細胞數(shù)都明顯高于健康對照組,且為有意義的統(tǒng)計學(xué)差異(P0.05)。血清TC、TG、LDL在冠心病伴牙周炎組和單純冠心病患者組中明顯高于牙周炎組和健康組,且差異有統(tǒng)計學(xué)意義(P0.05)。 2.牙周指標(biāo)結(jié)果： 四組中牙周各指標(biāo)(探診深度PD、齦溝出血指數(shù)SBI、附著喪失AL)存在顯著差異,且差異具有統(tǒng)計學(xué)意義(P0.001)。PD、SBI、AL在冠心病伴牙周炎組和單純慢性牙周炎組中都明顯高于單純冠心病組和健康參照組,且差異有統(tǒng)計學(xué)意義(P0.05)。 3.血清CRP濃度結(jié)果： 四組中血清CRP存在明顯差異,且均為有意義的統(tǒng)計學(xué)差異(P0.001)。其中,冠心病伴牙周炎組血清CRP高于慢性牙周炎組(PO.05),慢性牙周炎組高于冠心病組(P0.05),冠心病組高于健康參照組(P0.05)。 4.臨床血清學(xué)指標(biāo)和各牙周指標(biāo)的相關(guān)性： 血清WBC與牙周指標(biāo)PD、SBI、AL均存在正相關(guān)關(guān)系,相關(guān)系數(shù)r和P值分別為：r=0.500,P0.001;r=0.521,P0.001;r=0.555, P0.001。 5.血清CRP和各牙周指標(biāo)的相關(guān)性： 血清CRP與牙周指標(biāo)PD、SBI、AL均相關(guān),且為正相關(guān),相關(guān)系數(shù)r和P值分別為：r=0.500, P0.001;r=0.635, P0.001;r=0.702, P0.001。 6.血清CRP和臨床血清學(xué)指標(biāo)的相關(guān)性： 血清CRP與WBC相關(guān),并且是正相關(guān),相關(guān)系數(shù)r=0.500,P0.001。 結(jié)論： 1.血清CRP的水平由高到低依次為：冠心病伴牙周炎組、單純牙周炎組、冠心病組、健康組。說明CRP在冠心病和牙周炎的發(fā)生中起一定作用,牙周炎引起CRP水平增高。 2.CRP與牙周指標(biāo)存在相關(guān)性,說明CRP水平升高,牙周炎程度加重。
[Abstract]:objective
Coronary atherosclerotic heart disease (AS, also known as coronary heart disease, coronary heart disease, CHD) is now one of the most important diseases that affect the health and quality of life of the people. Chronic periodontitis (CP) is a bacterial microorganism that lurks around the periodontal tissue of the human mouth and is violated and damaged for a long time. Injury, which leads to local infection in the periodontal tissue of the human body, causes local tissue structure, function damage, and may cause damage to various systems (such as cardiovascular system) of the body. A large number of research results show the potential link between chronic periodontitis and coronary heart disease, such as smoking, hypertension, diabetes, obesity, blood lipid and so on. As a similar influence factor, it can promote and increase the prevalence of two diseases. The pathological nature of periodontitis and coronary heart disease is inflammatory infection of the body's corresponding tissues, the whole process of the disease is an inflammatory response, and the C- reactive protein (C-reactive protein, CRP) is extremely active and sensitive in the inflammatory response. One of the substances of sensation may be closely related to the two diseases. By studying the distribution of CRP in the serum and its relationship with the serology and periodontal indexes, this topic explores the correlation between CRP and the existence of these two diseases, and the key role it plays in the course of the disease.
Method
1. research goals
60 cases of coronary heart disease were first diagnosed as coronary heart disease in the Department of Cardiology of Shanxi cardiovascular hospital from 2013.9 to 2013.12 months, including 30 cases of coronary heart disease and periodontitis group (group CP) and 30 cases of simple coronary heart disease group (group C). 30 cases of single chronic periodontitis were selected from the out-patient and physical examination center of the provincial people's Hospital, and 30 cases of healthy volunteers were selected, respectively. Periodontitis group (group P), healthy control group (group H)
2. clinical data collection
General routine examination of 2.1.
All subjects were recorded in details of their age, sex, height, weight, smoking history, history of hypertension and systemic history. All the participants received blood biochemical tests, extracted the early morning venous blood, checked and registered the results of the related data. The specific registration results included the high density fat eggs in the serum. White (HDL-C), low density lipoprotein (LDL-C), total cholesterol (TC), triglyceride (TG), fasting blood glucose (FPG) and white blood cell count (WBC).
2.2. stomatological examination
A detailed and comprehensive examination of the periodontal tissue of each of the subjects was carried out to measure six dental sites representing the teeth (the middle point of the tongue and the palate side, the middle point and the far middle point, the middle point, the middle point and the far middle point of the cheek and cheek teeth, the PD), the gingival gingival bleeding index (SBI), and the loss of attachment (AL). The corresponding indicators are registered on the case.
Detection of serum CRP in 2.3.
Blood samples were taken from all subjects. Fasting venous blood was taken in the morning. Serum hs-CRP was detected by immunoturbidimetry and the results were registered.
Result錛，

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