【摘要】：目的探討牙周基礎(chǔ)治療對老年2型糖尿病(T2DM)牙周炎患者脂聯(lián)素、炎癥因子、糖代謝指標的影響。方法選擇患有T2DM的老年牙周炎患者98例,采用隨機數(shù)字表法分為對照組和觀察組,每組49例。兩組繼續(xù)糖尿病的基礎(chǔ)治療,對照組給予口腔衛(wèi)生指導(dǎo),觀察組在此基礎(chǔ)行牙周基礎(chǔ)治療。觀察比較兩組治療前后菌斑指數(shù)(PLI),探診深度(PD),齦溝出血指數(shù)(SBI)、空腹血糖(FPG),餐后2 h血糖(2 h PG),糖化血紅蛋白(Hb A1c),白細胞介素(IL)-1β、IL-6、腫瘤壞死因子(TNF)-α、脂聯(lián)素(APN)、載脂蛋白(Apo)A1水平。結(jié)果治療后,兩組PLI、PD、SBI均較治療前顯著降低(PLI對照組t=4.81,P=0.00,觀察組t=9.32,P=0.00;PD對照組t=3.75,P=0.00:觀察組t=7.54,P=0.00;SBI對照組t=4.74,P=0.00,觀察組t=9.10,P=0.00),且觀察組降低幅度明顯優(yōu)于對照組(均P0.05)。治療后,對照組糖代謝指標較治療前變化不顯著(P0.05),觀察組FPG、2 h PG及Hb A1c均較治療前顯著降低(t=2.45,P=0.008;t=5.61,P=0.00;t=2.40,P=0.008),較對照組治療后顯著降低(P0.05);兩組IL-1β、IL-6、TNF-α水平均明顯低于治療前(IL-1β對照組t=5.13,P=0.00,觀察組t=11.69,P=0.00,IL-6對照組t=14.59,P=0.00,觀察組t=32.41,P=0.00;TNF-α對照組t=5.69,P=0.00觀察組t=11.96,P=0.00),Apo A1、APN水平顯著高于治療前(APN對照組t=13.83,P=0.00,觀察組t=16.75,P=0.00;Apo A1對照組t=2.43,P=0.01,觀察組t=3.97,P=0.00)(P0.05),且觀察組各指標均較對照組顯著升高(均P0.05)。結(jié)論牙周基礎(chǔ)治療可以改善體內(nèi)糖代謝,降低炎癥因子水平,促進APN、Apo A1表達。
[Abstract]:Objective to investigate the effects of periodontal therapy on adiponectin, inflammatory factors and glucose metabolism in elderly patients with type 2 diabetes mellitus (T2DM). Methods 98 cases of senile periodontitis with T2DM were randomly divided into control group (n = 49) and observation group (n = 49). The two groups continued the basic treatment of diabetes, the control group was given oral hygiene guidance, the observation group was treated with periodontal basic therapy. The plaque index (PLI), probing depth (PD), gingival sulcus bleeding index (SBI), fasting blood glucose (FPG),) 2 h postprandial blood glucose (HbA1c), interleukin (IL) 1 尾 sil 6, tumor necrosis factor (TNF) 偽, adiponectin (APN), apolipoprotein (Apo) A1 were observed and compared between the two groups before and after treatment. Results after treatment, the levels of PLI in the control group were significantly lower than those in the control group (t = 4.81, P ~ (0.00), while in the control group, t ~ (3.75) P _ (P ~ (0.00); in the observation group, there was a significant difference between the control group and the control group (P < 0.05), and the decrease in the observation group was significantly higher than that in the control group (all P 0.05), and that in the observation group was significantly higher than that in the control group (all P 0.05), and that in the observation group was significantly higher than that in the control group (P < 0.05), while in the observation group, there was no significant difference between the two groups (P > 0.05). After treatment, There was no significant change in glucose metabolism in the control group (P0.05), but the levels of PG and HbA1c in the observation group were significantly lower than those before the treatment (t 2.45% P0. 008, P 0. 008), which were significantly lower than those in the control group (P0.05), and the levels of IL-1 尾-IL-6TNF- 偽 in the two groups were significantly lower than those before the treatment (IL-1 尾 control group, t5. 13P, P < 0. 008), while in the control group, the levels of IL-1 尾 -IL-6TNF- 偽 were significantly lower than those in the control group (P0.05), and the levels of TNF- 偽 in the two groups were significantly lower than those in the control group. The levels of APN in the control group were significantly higher than those before the treatment (APN control group, t13.83 P0. 00. the observation group was 16.75, the control group was t2.43 P0. 01, the observation group was t3.977P0.00) (P0.05), and each index in the observation group was significantly higher than that in the control group (P0.05), and the levels of APN in the observation group were significantly higher than those in the control group (all P 0.05). The levels of APN in the observation group were significantly higher than those in the control group (t 13.83 P0. 00. the observation group had a significant difference between the observation group and the control group (P 0.05). The results showed that the control group was significantly higher than that in the control group (P 0.05), and the control group was significantly higher than that in the control group (P 0.05), and the levels of APO A were significantly higher in the observation group than in the control group (P 0.05). Conclusion periodontal basic therapy can improve glucose metabolism, decrease the level of inflammatory factors and promote the expression of APN Apo A1 in vivo.
【作者單位】： 浙江蕭山醫(yī)院口腔科;
【分類號】：R587.1;R781.42

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