【摘要】：目的：探討逆行性牙髓炎皰疹病毒與五種牙周致病菌之間的關(guān)系以及逆行性牙髓炎疾病的致病危險(xiǎn)因素，初步了解皰疹病毒與牙周致病菌之間相互作用的機(jī)制，，為逆行性牙髓炎及重度牙周病損的臨床診治提供科學(xué)依據(jù)。 方法：以前期研究對(duì)38例逆行性牙髓炎牙髓組織和齦下菌斑以及30例牙周健康受試者的齦下菌斑樣本檢測(cè)五種牙周致病菌，伴放線聚集桿菌(Aggregatibacter actinomycetemcomitans, A.a.)，牙齦卟啉單胞菌(Porphyromonas gingivalis, P.g.）,中間普氏菌(Prevotella intermedia, P.i),福賽坦氏菌(Tannerella forsythensis, T.f.)，齒垢密螺旋體(Treponema denticola,T.d.)，以及皰疹病毒人巨細(xì)胞病毒（Human cytomegalovirus, HCMV）和EB病毒1型（Epstein-Barr virus-1, EBV-1）所獲得的數(shù)據(jù)為基礎(chǔ)，本研究整理前期數(shù)據(jù)，使用SPSS13.0軟件包，應(yīng)用行×列X2檢驗(yàn)比較各牙周致病菌在EBV-1/HCMV分層后的檢出率，應(yīng)用Spearman秩相關(guān)分析其相關(guān)性。應(yīng)用兩獨(dú)立樣本非參數(shù)秩和檢驗(yàn)Mann-Whitney U檢驗(yàn)方法比較各牙周致病菌在EBV-1/HCMV分層后的構(gòu)成比差異。應(yīng)用行×列X2檢驗(yàn)比較不同牙周致病菌檢出的種類數(shù)時(shí)皰疹病毒的檢出率。應(yīng)用單變量邏輯回歸分析齦下感染原對(duì)逆行性牙髓炎的相對(duì)危險(xiǎn)度，以及五種牙周致病菌構(gòu)成比對(duì)EBV-1/HCMV的相對(duì)危險(xiǎn)度。 結(jié)果：1.逆行性牙髓炎牙髓組織中EBV-1陽(yáng)性時(shí)P.g.和T.f.的檢出率高于EBV-1陰性時(shí)的檢出率。逆行性牙髓炎牙髓組織和齦下菌斑中EBV-1陽(yáng)性時(shí)T.f.的構(gòu)成比高于EBV-1陰性時(shí)的T.f.的構(gòu)成比。T.f.與EBV-1顯著相關(guān)，其比值比為1.10。 2.逆行性牙髓炎牙髓組織中HCMV陽(yáng)性時(shí)P.i.、T.f.、T.d.的構(gòu)成比高于HCMV陰性時(shí)的構(gòu)成比，且T.f在兩組中的差異具有統(tǒng)計(jì)學(xué)意義（P′=0.0490.05）。在逆行性牙髓炎齦下菌斑中HCMV陽(yáng)性時(shí)P.g.、T.f.的構(gòu)成比高于HCMV陰性時(shí)的構(gòu)成比。T.f.與HCMV相關(guān)性具有統(tǒng)計(jì)學(xué)意義，其比值比為1.06。 3.檢出3～5種牙周致病菌的逆行性牙髓炎牙髓樣本中，EBV-1的陽(yáng)性率顯著高于未檢出牙周致病菌的樣本，差異有統(tǒng)計(jì)學(xué)意義（х2=5.657，P=0.043）,且皰疹病毒陽(yáng)性樣本中感染3～5種牙周致病菌的樣本所占比例高于感染兩種及兩種以下致病菌樣本的比例。 4.逆行性牙髓炎的相對(duì)危險(xiǎn)因素為P.g.、P.i.、T.f.、T.d.和EBV-1、HCMV，其比值比分別為3.95,1.37,1.14,4.09,3.40和7.28。 結(jié)論：P.g.、P.i.、T.f.、T.d.和EBV-1、HCMV是逆行性牙髓炎疾病發(fā)病的危險(xiǎn)因素。EBV-1和HCMV與牙周致病菌之間可能存在相互作用，尤其是與P.g.和T.f.存在較為密切的交互影響。同時(shí)，多種細(xì)菌混合感染可能以聯(lián)合的形式與皰疹病毒相互作用，從而參與疾病的進(jìn)程。但是這五種牙周致病菌與皰疹病毒EBV-1和HCMV之間的相關(guān)性不強(qiáng)，提示可能還存在其他病原微生物或多種病原微生物聯(lián)合的形式與皰疹病毒相互影響，參與到逆行性牙髓炎疾病的致病機(jī)制中。
[Abstract]:Objective: to investigate the relationship between herpesvirus and five periodontal pathogens in retrograde pulpitis and the risk factors of retrograde pulpitis, and to understand the mechanism of the interaction between herpesvirus and periodontal pathogenic bacteria. To provide scientific basis for clinical diagnosis and treatment of retrograde pulpitis and severe periodontal disease. Methods: the subgingival plaque samples of 38 patients with retrograde pulpitis and subgingival plaque and 30 healthy subjects were studied for five kinds of periodontal pathogenic bacteria (Aggregatibacter actinomycetemcomitans, A. a.). Porphyromonas gingivalis (Porphyromonas gingivalis, P.g., (Prevotella intermedia, P.I, (Tannerella forsythensis, T.f., Treponema denticola,T.d., Based on the data obtained from herpesvirus human cytomegalovirus (Human cytomegalovirus, HCMV) and EB virus type 1 (Epstein-Barr virus-1, EBV-1), the preliminary data were collated and SPSS13.0 software package was used. The detection rate of periodontal pathogenic bacteria after EBV-1/HCMV stratification was compared by X column X 2 test and Spearman rank correlation analysis was used. The nonparametric rank sum test (Mann-Whitney U test) was used to compare the composition ratio of periodontal pathogenic bacteria after EBV-1/HCMV stratification. The detection rate of herpesvirus in different periodontal pathogenic bacteria was compared by X column X 2 test. The relative risk of subgingival infection to retrograde pulpitis and the relative risk of EBV-1/HCMV to five periodontal pathogens were analyzed by univariate logistic regression analysis. Results: 1. When EBV-1 was positive in pulp tissue of retrograde pulpitis, P.g. And T. F. The positive rate of EBV-1 was higher than that of EBV-1 negative. When EBV-1 was positive in pulp tissue and subgingival plaque of retrograde pulpitis, T. f. The ratio of T. f. was higher than that of T. f. when EBV-1 was negative. T. F. There was significant correlation with EBV-1, the ratio was 1. 10. 2. When HCMV was positive in pulp tissue of retrograde pulpitis, P. I. T. F. T. D. The ratio of T. f in the two groups was higher than that in the HCMV negative group (P < 0. 049. 05), and the difference between the two groups was statistically significant (P < 0. 049. 05). When HCMV was positive in subgingival plaque of retrograde pulpitis, P. T. F. The correlation with HCMV was statistically significant, and the ratio was 1. 06. 3. The positive rate of EBV-1 was significantly higher in the pulp samples of retrograde pulpitis with 35 periodontal pathogenic bacteria than that in the undetectable samples, and the difference was statistically significant (P 0.043). The proportion of 35 periodontal pathogens infected with herpesvirus positive samples was higher than that of the samples infected with two or less kinds of pathogenic bacteria. 4. The relative risk factors of retrograde pulpitis were P. The ratio to EBV-1,HCMV, is 3.95 ~ 1.37 ~ 1.144.09 ~ 3.40 and 7.28 respectively. Conclusion: P.g. P. I. C. T. F. T. D. EBV-1 and HCMV may interact with periodontal pathogens, especially P.g. And T. F. There is close interaction. At the same time, multiple bacterial mixed infections may interact with herpesvirus in the form of union, thus participating in the disease process. However, the correlation between these five periodontal pathogens and herpesvirus EBV-1 and HCMV is not strong, suggesting that there may be other pathogenic microorganisms or a combination of several pathogenic microorganisms and the interaction between herpesvirus and other pathogenic microorganisms. Participate in the pathogenesis of retrograde pulpitis.
【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】：2014
【分類號(hào)】：R781.31

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 鐘鈺;高碧云;黃燕琳;陳文霞;;紅色復(fù)合體與逆行性牙髓炎的相關(guān)性研究[J];口腔生物醫(yī)學(xué);2012年01期

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