【摘要】：目的：檢測(cè)牙周炎患者相關(guān)體液中褪黑素(melatonin, MT)、中瘤壞死因子-α (tumor necrosis factor-α, TNF-α)、白細(xì)胞介素-1β (interleukin-1β,IL-1β)表達(dá)水平并觀察齦下刮治對(duì)其表達(dá)水平的影響,結(jié)合牙周臨床指標(biāo),探討褪黑素在牙周炎發(fā)病機(jī)制中的可能作用。方法：根據(jù)rmitage的牙周炎診斷標(biāo)準(zhǔn)納入牙周炎初診患者27例。同時(shí)納入無系統(tǒng)疾病且牙周健康者18例作為健康對(duì)照組。收集患者病史資料及曲面斷層片,進(jìn)行牙周�？茩z查確定取樣牙位,并進(jìn)行齦上潔治,1周后行齦下刮治,4周后復(fù)診。分別于齦下刮治前及刮治后4周復(fù)診時(shí),記錄臨床指標(biāo)并采集血液、唾液及取樣牙牙位齦溝液(gingival crevicular fluid, GCF)。記錄健康對(duì)照組牙周臨床指標(biāo)并采集血液和唾液。采用酶聯(lián)免疫吸附試驗(yàn)(enzyme-linked immunosorbent assay, ELISA)檢測(cè)樣本中MT、TNF-α及IL-1β的濃度,應(yīng)用秩和檢驗(yàn)比較其在牙周炎組與健康對(duì)照組中的表達(dá)差異,并比較牙周炎組齦下刮治前后其表達(dá)水平的變化,運(yùn)用Spearman秩相關(guān)檢驗(yàn)分析樣本中MT、TNF-α、IL-1β與牙周臨床指標(biāo)探診深度(probing depth, PD)、探診出血(bleeding on probing, BOP)、附著喪失(clinical attachment level, CAL)的相關(guān)關(guān)系。結(jié)果：1、牙周炎組患者血液中MT水平刮治前低于刮治后(Z=-2.186,P=0.029),且均低于健康對(duì)照組(P0.001);牙周炎組患者唾液中MT水平在刮治前、后和健康對(duì)照組三組間相比差異均無統(tǒng)計(jì)學(xué)意義(P0.05)；牙周炎組患者GCF中MT水平刮治前高于刮治后(Z=-2.667,P0.001)。2、刮治前,牙周炎組患者血液、唾液與GCF中MT水平無明顯相關(guān)性；健康對(duì)照組中血液和唾液MT水平無明顯相關(guān)性。3、牙周炎組患者IL-1β、TNF-α與牙周臨床指標(biāo)的關(guān)系：刮治前唾液中IL-1β、TNF-α與牙周臨床指標(biāo)無明顯相關(guān)性；GCF中IL-1β水平與取樣牙PD成正相關(guān)(r=0.350,P=0.041),與取樣牙BOP陽性率成正相關(guān)(r=0.514,P=0.011),TNF-α水平與取樣牙PD成正相關(guān)(r=0.304,P=0.045),與取樣牙BOP陽性率成正相關(guān)(r=0.427,P=-0.036)。其余指標(biāo)無明顯相關(guān)性。4、牙周炎組患者M(jìn)T與牙周臨床指標(biāo)的關(guān)系：刮治前血液MT水平與全口PD (r=-0.465, P=0.034)、BOP (r=-0.466, P=0.025)均成負(fù)相關(guān)；唾液MT水平與全口BOP陽性率成負(fù)相關(guān)(r=0.401,P=0.021)；GCF中MT水平與取樣牙PD成正相關(guān)(r=0.465,P=0.045)。其余指標(biāo)無明顯相關(guān)性。5、牙周炎組患者M(jìn)T與IL-1β,TNF-α的關(guān)系：刮治前唾液中MT與IL-1β,TNF-α無明顯相關(guān)；GCF中MT水平與IL-1β水平呈正相關(guān)(r=0.442,P=0.015),與TNF-α無明顯相關(guān)。6、Logistic回歸分析結(jié)果顯示血液MT水平與牙周炎OR值為0.756(B=-0.280,P=0.030,95%CI：0.587-0.974),提示高水平血液MT為牙周炎的保護(hù)因素。結(jié)論：1、牙周炎患者GCF中MT水平與IL-1β水平正相關(guān),且與PD成正相關(guān),提示MT與牙周炎癥嚴(yán)重程度正相關(guān)。2、牙周炎患者血液中MT呈低表達(dá)水平,在GCF中MT可能為局部誘導(dǎo)上調(diào)表達(dá)。
[Abstract]:Objective: to detect the expression of tumor necrosis factor- 偽 (TNF- 偽) and interleukin-1 尾 (interleukin-1 尾 -IL-1 尾) in melatonin (melatonin, MT), and observe the effect of subgingival curettage on the expression of melatonin (melatonin, MT), in patients with periodontitis. To explore the possible role of melatonin in the pathogenesis of periodontitis. Methods: according to the rmitage criteria of periodontitis, 27 patients with periodontitis were included. At the same time, 18 patients with no systemic disease and periodontal health were included as healthy control group. Collect the patient's medical history and curved surface tomograph, make periodontal examination to determine the position of the sampled teeth, and do the supragingival scaling for 1 week and then the subgingival curettage for 4 weeks. Before and 4 weeks after subgingival curettage, clinical data were recorded and (gingival crevicular fluid, GCF). Was collected from blood, saliva and gingival crevicular fluid. The periodontal clinical indexes were recorded and blood and saliva were collected in healthy control group. Enzyme linked immunosorbent assay (enzyme-linked immunosorbent assay, ELISA) was used to detect the concentration of MT,TNF- 偽 and IL-1 尾 in the samples. The expression of MT,TNF- 偽 and IL-1 尾 in periodontitis group was compared with that in healthy control group by rank sum test, and the expression level of MT,TNF- 偽 and IL-1 尾 in periodontitis group was compared before and after subgingival curettage. Spearman rank correlation test was used to analyze the relationship between MT,TNF- 偽 IL-1 尾 and periodontal clinical index, the depth of (probing depth, PD), probing bleeding, (bleeding on probing, BOP), attachment and loss of (clinical attachment level, CAL). Results the blood MT level in the periodontitis group was lower than that in the control group before and after curettage (P0. 001) and was lower than that in the healthy control group (P0. 001), but there was no significant difference between the three groups before and after the curettage (P0.05). The level of MT in GCF of periodontitis group was higher than that after curettage (ZP0.001). Before curettage, there was no significant correlation between blood, saliva and MT level in GCF in periodontitis group. There was no significant correlation between MT level in blood and saliva in healthy control group. The relationship between IL-1 尾 TNF- 偽 and periodontal clinical index in periodontitis group: there was no significant correlation between IL-1 尾 -TNF- 偽 in saliva and periodontal clinical index before curettage. The level of IL-1 尾 in GCF was positively correlated with the PD of sampled teeth (r = 0.350), and with the positive rate of BOP in sampled teeth (r = 0.514). There was a positive correlation between the level of TNF- 偽 and the PD of sampled teeth (r = 0.304), and a positive correlation with the positive rate of BOP in sampled teeth (r ~ (0.427) P ~ (-0.036). There was no significant correlation between other indexes. The relationship between MT and periodontal clinical indexes in periodontitis group: before curettage, there was a negative correlation between MT level in blood and PD (r-0.466, P0. 025) in the whole mouth, and there was a negative correlation between MT level in saliva and the positive rate of BOP in the whole mouth (r0. 401, P0. 021). There was a positive correlation between MT level in GCF and PD in sampled teeth (r = 0.465, P = 0.045). There was no significant correlation between MT and IL-1 尾 TNF- 偽 in periodontitis patients. There was no significant correlation between MT and IL-1 尾 TNF- 偽 in saliva before curettage. There was a positive correlation between MT level and IL-1 尾 level in GCF (r = 0.442 P 0.015), but no significant correlation with TNF- 偽. Logistic regression analysis showed that the serum MT level and OR value of periodontitis were 0.756 (BM-0.280), suggesting that the high level of blood MT was the protective factor of periodontitis. Conclusion MT level in GCF of periodontitis patients is positively correlated with IL-1 尾 level, and is positively correlated with PD, suggesting that MT is positively correlated with the severity of periodontitis, and MT expression is low in the blood of periodontitis patients. In GCF, MT may be locally induced and up-regulated.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R781.42

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 甘建華;;牙周與正畸聯(lián)合治療牙周炎患者的臨床治療效果探析[J];當(dāng)代醫(yī)學(xué);2013年34期

2 毛釗,楊儉,丁傳林,于曉勤;老年牙周炎患者中性粒細(xì)胞的研究[J];醫(yī)學(xué)研究生學(xué)報(bào);2000年02期

3 王去非,王佩,吳錫銘;牙周炎患者唾液中多胺水平的改變[J];口腔醫(yī)學(xué);2003年02期

4 徐國(guó)超;牙周炎患者血小板聚集性的觀察[J];牙體牙髓牙周病學(xué)雜志;2003年09期

5 楊nr波;董青;張彬;陳乃玲;;牙周炎患者的正畸治療[J];中國(guó)煤炭工業(yè)醫(yī)學(xué)雜志;2006年07期

6 施捷;朱衛(wèi)東;;牙周炎患者的正畸治療及其遠(yuǎn)期療效觀察[J];口腔正畸學(xué);2007年04期

7 邢鳳梅;;57例牙周炎患者綜合治療結(jié)果分析[J];中外醫(yī)療;2009年09期

8 韓春華;馬敏;李國(guó)凱;張慶;;寧夏地區(qū)回族、漢族牙周炎患者血脂水平的分析[J];口腔醫(yī)學(xué)研究;2010年05期

9 王鳳霞;;牙周和正畸聯(lián)合治療牙周炎患者臨床分析[J];吉林醫(yī)學(xué);2012年06期

10 惠光艷;吳廣升;;牙周非手術(shù)治療對(duì)2型糖尿病伴牙周炎患者白介素-23及代謝指標(biāo)的影響[J];中國(guó)療養(yǎng)醫(yī)學(xué);2013年08期

相關(guān)會(huì)議論文 前8條

1 陳宏柏;陳作良;;吸煙與難治性牙周炎[A];FDI、CSA臨床口腔進(jìn)展學(xué)術(shù)會(huì)議論文匯編[C];1999年

2 嚴(yán)娟;張雪玲;陳佩珠;;多媒體課件在牙周炎患者健康教育中的應(yīng)用[A];全國(guó)口腔科護(hù)理學(xué)術(shù)交流暨專題講座會(huì)議論文匯編[C];2008年

3 林梅;王左敏;李一梓;李威;趙倩;張?bào)?張良瓊;王辰;;慢性阻塞性肺疾病及牙周炎患者血清白介素-33的檢測(cè)及意義[A];中華口腔醫(yī)學(xué)會(huì)全科口腔醫(yī)學(xué)專業(yè)委員會(huì)第一次學(xué)術(shù)年會(huì)會(huì)議論文集[C];2009年

4 葛超榮;;慢性牙周炎患者口腔微生態(tài)特征初步研究[A];2008年浙江省檢驗(yàn)醫(yī)學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2008年

5 丁俊清;張周文;馮翠蘭;蔡楙琴;;牙周炎與唾液性激素關(guān)系的探討[A];中華口腔醫(yī)學(xué)會(huì)成立大會(huì)暨第六次全國(guó)口腔醫(yī)學(xué)學(xué)術(shù)會(huì)議論文匯編[C];1996年

6 陳淑;管兆蘭;;老年牙周炎患者行激光治療術(shù)的護(hù)理[A];全國(guó)口腔護(hù)理新進(jìn)展研討會(huì)論文匯編[C];2010年

7 馮利;何健民;郭敏;;牙周炎遺傳因素的探討[A];遺傳學(xué)進(jìn)步與人口健康高峰論壇論文集[C];2007年

8 金晶;許春姣;袁海波;邱喜麗;王璐;徐文華;周美璐;;慢性牙周炎患者齦溝液及牙齦組織中Dkk1水平的檢測(cè)[A];第十次全國(guó)牙周病學(xué)學(xué)術(shù)會(huì)議論文摘要匯編[C];2014年

相關(guān)重要報(bào)紙文章 前1條

1 牛斯;“牙齒再生醫(yī)療” 造福牙周炎患者[N];醫(yī)藥經(jīng)濟(jì)報(bào);2002年

相關(guān)博士學(xué)位論文 前2條

1 孫偉蓮;牙周干預(yù)對(duì)伴2型糖尿病牙周炎患者脂聯(lián)素、炎性因子和糖脂代謝的影響[D];浙江大學(xué);2012年

2 郭世杰;血漿內(nèi)毒素在牙周炎患者罹患冠心病中的作用及機(jī)制研究[D];天津醫(yī)科大學(xué);2013年

相關(guān)碩士學(xué)位論文 前10條

1 程宇釗;比較OSAHS及OSAHS合并牙周炎患者唾液IL-6和TNF-α水平的變化[D];山西醫(yī)科大學(xué);2015年

2 趙家珍;慢性牙周炎患者唾液miRNA-146a的表達(dá)及其臨床意義分析[D];南方醫(yī)科大學(xué);2015年

3 宋倩;白介素17在哈薩克族2型糖尿病伴牙周炎患者血清及唾液的表達(dá)及相關(guān)性研究[D];新疆醫(yī)科大學(xué);2015年

4 鄭品軒;2型糖尿病伴牙周炎患者頜骨骨髓間充質(zhì)干細(xì)胞骨向分化能力的研究[D];遵義醫(yī)學(xué)院;2016年

5 閆艷梅;1,25(OH)_2D3對(duì)2型糖尿病伴牙周炎患者中性粒細(xì)胞相關(guān)功能的影響[D];遵義醫(yī)學(xué)院;2016年

6 吳芳;慢性牙周炎患者和牙周健康人唾液微生物多樣性[D];蘭州大學(xué);2016年

7 林桂蘭;牙周炎患者齦下刮治前后褪黑素表達(dá)水平的研究[D];廣西醫(yī)科大學(xué);2016年

8 張梅;伴有冠心病的牙周炎患者齦下菌斑中牙周炎相關(guān)致病菌的檢測(cè)[D];山東大學(xué);2009年

9 高春梅;牙周炎患者種植義齒的臨床療效評(píng)價(jià)[D];山東大學(xué);2009年

10 齊佳妮;牙周炎患者種植二期術(shù)后牙齦愈合狀況的研究[D];山東大學(xué);2013年

，

本文編號(hào)：2218041