本文選題：牙周炎 + 動脈粥樣硬化��； 參考：《山西醫(yī)科大學》2014年碩士論文

【摘要】：目的 通過檢測伴動脈粥樣硬化（atherosclerosis，As）的慢性牙周炎（chronicperiodontitis，CP）大鼠血清白細胞介素-6（Interleukin-6，IL-6）的濃度和頸動脈基質(zhì)金屬蛋白酶-2（Metalloproteinase-2，MMP-2）、基質(zhì)金屬蛋白酶-9（Metalloproteinase-9，MMP-9）的表達情況，研究輔以抗生素的牙周機械治療對As病變的影響。 方法 44只清潔級SD大鼠按隨機數(shù)字表隨機分為3大組，分別為A組（正常對照組）、B組（As組）、C組（CP+As組）。建模后，將C組再應(yīng)用隨機數(shù)字表分為4小組：C1自然進程組、C2單純機械治療組、C3機械治療+派麗奧組和C4機械治療+派麗奧+抗生素組。分別于建模后第1周、第3周、第5周、第7周和第9周酶聯(lián)免疫吸附（ELISA）法檢測血清中IL-6的濃度，，免疫組化法定性檢測各組頸動脈血管壁組織的MMP-2、MMP-9并測量其灰度值。 結(jié)果 1. MMP-2、MMP-9灰度值趨勢基本一致，B、C組頸動脈的內(nèi)、中膜均可見MMP-2、MMP-9高表達，其陽性染色深度均明顯大于A組（P0.05）。B組可見大量泡沫細胞及平滑肌細胞，彈性纖維明顯紊亂破壞；C1組（MMP-2，9灰度值分別為101.32.4、101.24.1）有動脈粥樣硬化斑塊形成，其陽性染色范圍最大，染色深度明顯強于B組（灰度值分別為126.42.0、124.82.8）（P0.05）；C2組血管壁厚薄不均，可見泡沫細胞， C3組血管壁增厚較輕，彈性纖維排列較整齊，C4組血管壁增厚，彈力纖維明顯，可見泡沫細胞及SMC， C2、C3和C4組MMP-2、MMP-9免疫組化陽性染色范圍及程度依次減弱，且均弱于C1組，灰度值差異有統(tǒng)計學意義（C2:134.53.1、136.73.2，C3:159.14.4、160.42.4， C4：170.32.3、168.82.2）（P0.05）。 2.血清結(jié)果顯示，隨著時間推移，B、C1組血清IL-6濃度一直呈升高趨勢，均明顯高于A組（P0.01）；C2、C3、C4組血清IL-6濃度均為先升后降，在建模后第5周達到峰值，其中C2組最高，從第4次取樣時間點起，各組IL-6含量均顯著低于C1組（P0.001），C3、C4組顯著低于C2組（P0.01）。 結(jié)論 1.對于伴有As的CP大鼠，牙周機械治療可能會短期內(nèi)增高機體炎癥，而長期則可能降低血管炎癥，減緩其As病變程度； 2.牙周機械治療時輔以局部及全身抗炎藥物后，頸動脈血管病變及全身炎癥可以得到更好的改善； 3.若不及時控制慢性牙周炎癥，則可能會加重As的病變程度,促進其動脈粥樣硬化斑塊的形成。
[Abstract]:Purpose The serum levels of interleukin-6 (IL-6) and the expression of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) in chronic periodontitis rats with atherosclerosis were determined. To study the effect of periodontal mechanical therapy with antibiotics on as lesions. Method Forty-four SD rats of clean grade were randomly divided into three groups: group A (normal control group, group B) and as group C (group C). After modeling, group C was randomly divided into 4 groups: C1 natural process group, C2 mechanical treatment group, C 3 mechanical therapy group and C4 mechanical treatment group. The concentration of IL-6 in serum was detected by Elisa at week 1, week 3, week 5, week 7 and week 9, respectively, and MMP-2 MMP-9 in carotid artery wall tissue was detected qualitatively by immunohistochemical method and its gray value was measured. Result 1. The intensity of MMP-2 and MMP-9 were similar in the carotid artery, and the high expression of MMP-2MMP 9 was found in the middle membrane. The positive staining depth of MMP-2MMP 9 was significantly higher than that in group A (P 0.05) and smooth muscle cells (SMC) were found in group B (P 0.05), and in group B (P 0.05), a large number of foam cells and smooth muscle cells were found. There were atherosclerotic plaques in group C _ 1, and the positive staining range was the largest, and the depth of staining was significantly stronger than that in group B (grayscale values were 126.42.0124.82.82.82.82.84.82.8respectively, the thickness and thickness of vascular wall were uneven in group C _ 2, P 0.05C _ 2, P _ (0.05) C _ 2, P _ (0.05) C _ (2), P _ (0.05) P _ (0.05) C _ 2). Foam cells were seen in C _ 3 group. The thickening of vascular wall and elastic fibers were observed in C _ 3 group and C _ 4 group. The range and degree of immunohistochemical staining of foam cell and SMC, C _ 2C _ 3 and C _ 4 group were decreased in turn. The grayscale value of C _ 2: 134.53.1136.73.2C _ 3: 159.14.4160.42.4 and C _ 4: 170.32. 3168.82.2 respectively were significantly different from that of C _ 2: 134.53.1136.73.2and C _ 4: 170.32. 33168.82.2 respectively. 2. The results showed that the serum IL-6 concentration in group C 1 was higher than that in group A (P 0.01) and then decreased, and reached the peak at the 5th week after modeling, and the highest in group C 2, and the concentration of IL-6 in group C 2 was higher than that in group C 2. From the time point of the fourth sampling, the content of IL-6 in each group was significantly lower than that in C _ 1 group (P 0.001) and C _ (3) C _ (3) C _ (4) group was significantly lower than that in C _ 2 group (P 0.01). Conclusion 1. For CP rats with as, periodontal mechanical therapy may increase inflammation in a short period of time, but in the long run it may decrease inflammation of blood vessels and slow down the degree of as lesion. 2. After periodontal mechanical treatment with local and systemic anti-inflammatory drugs, carotid artery lesions and systemic inflammation can be better improved. 3. If chronic periodontitis is not controlled in time, it may aggravate the pathological degree of as and promote the formation of atherosclerotic plaque.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R781.4;R543.5

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