高血压、2型糖尿病并发牙周炎患者超敏C-反应蛋白及炎性细胞因子表达分析

目的: 观察高血压、2型糖尿病并发牙周炎患者血清超敏C-反应蛋白(high sensitive C-reactive protein,hs-CRP)、白介素-1β(interleukin 1β,IL-1β)、白介素-6(interleukin 6,IL-6)和肿瘤坏死因子-α(tumor necrosis factors-α,TNF-α)表达情况,探讨高血压、2型糖尿病对牙周炎发生与发展的影响。方法: 从某医院体检人群中筛选140名患者(单纯牙周炎组40名、高血压并发牙周炎组35名、2型糖尿病并发牙周炎组40名和2型糖尿病合并高血压并发牙周炎组25名)作为研究对象,记录其牙周探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、菌斑指数(plaque index,PLI)和出血指数(bleeding index,BI),并检测外周血hs-CRP、IL-1β、IL-6和TNF-α的浓度。结果: 2型糖尿病合并高血压并发牙周炎组PD、AL、PLI、BI指标检测结果高于单纯牙周炎组、高血压并发牙周炎组和2型糖尿病并发牙周炎组(P＜0.05),高血压并发牙周炎组和2型糖尿病并发牙周炎组高于单纯牙周炎组(P＜0.05);2型糖尿病合并高血压并发牙周炎组hs-CRP、IL-1β、IL-6和TNF-α检测结果高于单纯牙周炎组、高血压并发牙周炎组和2型糖尿病并发牙周炎组(P＜0.05),高血压并发牙周炎组和2型糖尿病并发牙周炎组高于单纯牙周炎组(P＜0.05)。患者血压、血糖水平与hs-CRP、IL-1β、IL-6和TNF-α水平呈正相关(P＜0.01)。结论: 高血压、2型糖尿病,尤其是高血压合并2型糖尿病并发牙周炎患者血清hs-CRP、IL-1β、IL-6和TNF-α水平较高,提示高血压合并2型糖尿病可能会加重牙周炎症发生与发展的风险。

The expression of high sensitive C-reactive protein and inflammation cytokines in periodontitis patients with hypertension and type 2 diabetes mellitus

AIM: To observe the levels of serum high sensitive C-reactive protein(hs-CRP), interleukin 1β(IL-1β), interleukin 6(IL-6) and tumor necrosis factors-α(TNF-α) in periodontitis patients with hypertension, type 2 diabetes mellitus and investigate the effect of hypertension, type 2 diabetes on the occurrence and development of periodontitis.METHODS: 140 patients from a hospital physical examination population (40 with only periodontitis, 35 with periodontitis and hypertension,40 with periodontitis and type 2 diabetes mellitus,25 with periodontitis and hypertension and type 2 diabetes mellitus ) were included in this study. Periodontal examinations,including periodontal probing depth(PD), attachment loss (AL), plaque index (PLI), bleeding index(BI) were recorded. The peripheral blood levels of hs-CRP,IL-1β,IL-6 and TNF-α were measured.RESULTS: The levels of PD,AL,PLI,BI in type 2 diabetes mellitus and hypertension complicated with periodontitis group were higher than those in periodontitis group,hypertension with periodontitis group and type 2 diabetes mellitus with periodontitis group (P<0.05). Those in hypertension complicated with periodontitis group , type 2 diabetes mellitus complicated with periodontitis group were higher than those in simple periodontitis group (P< 0.05).The levels of hs-CRP, IL-1β, IL-6 and TNF-α in type 2 diabetes mellitus and hypertension complicated with periodontitis group were higher than those in periodontitis group, hypertension with periodontitis group and type 2 diabetes mellitus with periodontitis group (P<0.05). Those in hypertension complicated with periodontitis group and type 2 diabetes mellitus complicated with periodontitis group were higher than simple periodontitis group (P<0.05).The levels of blood pressure and blood glucose in patients were the positive correlation with the levels of hs-CRP, IL-1β,IL-6 and TNF-α(P<0.01).CONCLUSION: The levels of hs-CRP, IL-1 beta, IL-6 and TNF-α in periodontitis patients with hypertension or type 2 diabetes mellitus, especially with type 2 diabetes mellitus and hypertension,were high, suggesting that hypertension complicated with type 2 diabetes mellitus may affect the occurrence and development of periodontitis.