本文選題：牙周基礎治療 + 2型糖尿病　； 參考：《青島大學》2017年碩士論文

【摘要】：研究目的:糖尿病是一種由于糖代謝障礙引起的,以多飲、多食、多尿、消瘦為特征的代謝性疾病,嚴重影響患者的身心健康,2型糖尿病是糖尿病的主要類型,發(fā)病占糖尿病患者90%以上;而牙周炎以破壞牙齒支持組織為特征,在我國發(fā)病率高達80%以上,以慢性牙周炎最為常見,占所有牙周炎患者的95%。糖尿病與牙周炎存在明確的相關關系,擁有共同的臨床危險因素。然而,牙周炎與糖尿病的相互作用機制尚不清楚,成為牙周醫(yī)學研究的難點。本研究目的為探討牙周基礎治療對2型糖尿病伴慢性牙周炎患者血清及齦溝液中瘦素,內(nèi)脂素濃度和胰島素抵抗的影響,以期更好地了解2型糖尿病伴慢性牙周炎患者全身及局部的炎癥狀況,為認識糖尿病及牙周炎的相互影響機制,提供新的研究思路。研究方法:實驗選取30例2型糖尿病伴慢性牙周炎患者,所有患者均來自青島大學附屬醫(yī)院口腔科、內(nèi)分泌門診及病房,將研究對象按照是否接受牙周基礎治療隨機分為治療組和對照組。治療組患者進行牙周基礎治療,治療內(nèi)容包括口腔衛(wèi)生宣傳教育、全口齦上潔治、齦下刮治,根面平整,對照組僅進行口腔衛(wèi)生宣傳教育。分別記錄治療前后兩組牙周指數(shù),包括菌斑指數(shù)(PLI)、探診深度(PD),附著喪失(AL),測定糖化血紅蛋白水平(Hb A1c),胰島素抵抗指數(shù)(HOMA-IR)并收集治療前及治療后3個月血清及齦溝液樣本,采用酶聯(lián)免疫吸附試驗方法測定瘦素、內(nèi)脂素濃度。比較各組治療前后牙周指數(shù)、Hb A1c、HOMA-IR及脂肪因子含量的變化,分析脂肪因子水平與其他指標的相關性。結果:與牙周基礎治療前相比,治療后3個月,治療組局部牙周炎癥得到顯著改善,表現(xiàn)在PLI、PD、AL水平顯著下降(P0.05),對照組改變不具有統(tǒng)計學意義;齦溝液中瘦素水平顯著上升,內(nèi)脂素水平顯著下降,血清中瘦素及內(nèi)脂素濃度顯著下降,且差異具有統(tǒng)計學意義(P0.05),而對照組無明顯變化(P0.05);治療組Hb A1c水平及HOMA-IR較基線顯著下降(P0.05),而對照組變化無統(tǒng)計學意義(P0.05);血清中內(nèi)脂素水平與Hb A1c呈正相關(r=0.839,P0.05),齦溝液中瘦素水平和PD呈負相關(r=-0.775,P0.05)。結論:牙周基礎治療可顯著改善2型糖尿病伴慢性牙周炎患者牙周炎癥、糖化血紅蛋白水平及胰島素抵抗指數(shù);牙周基礎治療可升高2型糖尿病伴慢性牙周炎患者的齦溝液瘦素水平、降低齦溝液內(nèi)脂素水平,兩者水平的變化可能與牙周炎癥的改善相關;而2型糖尿病伴慢性牙周炎患者血糖的改善可能與血清中瘦素、內(nèi)脂素水平降低相關。
[Abstract]:Objective: diabetes is a metabolic disease caused by impaired glucose metabolism, characterized by polydrink, polydiet, polyuria and wasting. Type 2 diabetes is the main type of diabetes mellitus, which seriously affects the physical and mental health of patients. The incidence of periodontitis is more than 80% in China, and chronic periodontitis is the most common disease, accounting for 95% of all periodontitis patients. Diabetes has a clear correlation with periodontitis and has a common clinical risk factor. However, the mechanism of periodontitis and diabetes is not clear, and become a difficult point in periodontal medicine. Objective to investigate the effects of periodontal basic therapy on serum and gingival crevicular fluid concentrations of leptin, endolipidins and insulin resistance in patients with type 2 diabetes mellitus with chronic periodontitis. To better understand the systemic and local inflammation in patients with type 2 diabetes mellitus and chronic periodontitis, and to provide new research ideas for understanding the interaction mechanism of diabetes mellitus and periodontitis. Methods: thirty patients with type 2 diabetes mellitus with chronic periodontitis were selected. All the patients were from the Department of Stomatology, Endocrine Clinic and Ward, affiliated Hospital of Qingdao University. The subjects were randomly divided into treatment group and control group according to whether or not they received periodontal basic therapy. The patients in the treatment group were treated with periodontal basic treatment, including oral health education, whole gingival scaling, subgingival curettage, and flat root surface, while the control group only carried out oral health education. The periodontal index, including plaque index (PLI), depth of diagnosis (PD), attachment loss (ALP), HbA1cI, insulin resistance index (HOMA-IRR) before and after treatment were recorded, and serum and gingival crevicular fluid (GCF) samples were collected before and after treatment. The concentrations of leptin and endolipin were determined by enzyme-linked immunosorbent assay (Elisa). The changes of HOMA-IR and fat factor content in periodontal index (HbA1cU) before and after treatment were compared, and the correlation between the level of fat factor and other indexes was analyzed. Results: compared with those before basic periodontal treatment, the local periodontitis was significantly improved in the treatment group 3 months after treatment, which showed that the level of PLI PDL decreased significantly (P 0.05), the change in the control group was not statistically significant, and the level of leptin in gingival crevicular fluid increased significantly. The levels of endolipidins and leptin in serum decreased significantly, and the concentrations of leptin and endolipidins in serum decreased significantly. The difference was statistically significant (P 0.05), but there was no significant change in the control group (P 0.05), the level of HB A1c and HOMA-IR in the treatment group decreased significantly compared with the baseline (P 0.05), but the change in the control group was not statistically significant (P 0.05), and the serum lipid level was positively correlated with HB A 1c (0.839 P 0.05) and gingival crevicular fluid (GCF). There was a negative correlation between leptin level and PD. Conclusion: periodontal basic therapy can significantly improve periodontitis, glycosylated hemoglobin level and insulin resistance index in patients with type 2 diabetes mellitus and chronic periodontitis. The level of leptin in gingival crevicular fluid was increased and the level of lipopolipin in gingival crevicular fluid was decreased in patients with type 2 diabetes mellitus and chronic periodontitis after periodontal treatment. The changes of both levels may be related to the improvement of periodontitis. The improvement of blood glucose in type 2 diabetic patients with chronic periodontitis may be related to the decrease of serum leptin and endolipidin levels.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R587.1;R781.42

【參考文獻】

相關期刊論文 前5條

1 曹思遠;郭陽;謝曉華;劉楓晨;裴路;;牙周基礎治療對2型糖尿病患者血清瘦素含量影響研究[J];實用口腔醫(yī)學雜志;2012年02期

2 危晶晶;常春榮;潘亞萍;俞寧;趙宏;;牙周非手術治療對2型糖尿病伴牙周炎患者糖代謝及血清白細胞介素6的影響[J];中華口腔醫(yī)學雜志;2011年02期

3 ;Nicotinamide overload may play a role in the development of type 2 diabetes[J];World Journal of Gastroenterology;2009年45期

4 楊媚;楊剛毅;李伶;李清明;阮華玲;陽皓;李鈳;孫勤;唐毅;Gunther Boden;;不同糖耐量個體血漿內(nèi)脂素水平的變化[J];中華內(nèi)分泌代謝雜志;2006年03期

5 郝梅,柳潔,原韶鐘,雷建華,謝敦祥;牙周非手術治療對糖尿病患者糖代謝及TNF-α的影響[J];現(xiàn)代口腔醫(yī)學雜志;2005年04期

，

本文編號：1885915