北京大学学报（医学版） ›› 2024, Vol. 56 ›› Issue (2): 332-337. doi: 10.19723/j.issn.1671-167X.2024.02.021
Ⅲ期或Ⅳ期牙周炎患者龈沟液中有机酸浓度与牙周炎的关系
胡玉如,刘娟,李文静,赵亦兵,李启强,路瑞芳*(
),孟焕新*()
- 北京大学口腔医学院·口腔医院牙周科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081
Relationship between short-chain fatty acids in the gingival crevicular fluid and periodontitis of stage Ⅲ or Ⅳ
Yuru HU,Juan LIU,Wenjing LI,Yibing ZHAO,Qiqiang LI,Ruifang LU*(),Huanxin MENG*()
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
摘要：
目的: 分析Ⅲ期或Ⅳ期牙周炎患者龈沟液(gingival crevicular fluid，GCF)中甲酸、丙酸和丁酸的浓度及其与牙周炎的关系。方法: 选择2008年2月至2011年5月于北京大学口腔医院牙周科就诊的37例全身健康的牙周炎患者作为病例组，选择同期19例全身及牙周健康志愿者作为对照组。每位研究对象每象限选一颗磨牙或切牙的颊侧近中位点采集龈沟液，并记录菌斑指数(plaque index，PLI)、探诊深度(probing depth，PD)、出血指数(bleeding index，BI)和附着丧失(attachment loss，AL)。分离上清液采用高效毛细管电泳技术检测甲酸、丙酸和丁酸的浓度，分析其对牙周炎患病风险的预测能力，以及与牙周炎分级的相关性。结果: 病例组37例牙周炎患者按分期32例为Ⅲ期和5例为Ⅳ期，按分级9名为B级和28名为C级。病例组患者的临床指标均显著高于对照组(P＜0.001)，龈沟液中甲酸含量明显低于对照组[5.37(3.39，8.49) mmol/L vs. 12.29(8.35，16.57) mmol/L，P＜0.001]，而丙酸和丁酸浓度均显著高于对照组[10.23(4.28，14.90) mmol/L vs. 2.71(0.00，4.25) mmol/L，P＜0.001；2.63(0.47，3.81) mmol/L vs. 0.00(0.00，0.24) mmol/L，P＜0.001]。B级和C级牙周炎龈沟液中甲酸、丙酸和丁酸的浓度差异无统计学意义(P＞0.05)。而深袋内丙酸和丁酸的浓度明显高于浅袋，甲酸浓度随袋深的增加反而减少。丙酸(OR=1.51，95%CI：1.29~1.75)和丁酸(OR=3.72，95%CI：1.93~7.17)是牙周炎的危险因素，而甲酸(OR=0.87，95%CI：0.81~0.93)则可能是牙周炎的保护因素。丙酸(AUC=0.852，95%CI：0.805~0.900)、丁酸(AUC=0.889，95%CI：0.841~0.937)、甲酸浓度的倒数(AUC=0.844，95%CI：0.793~0.895)对牙周炎的患病风险具有良好的预测能力。结论: 牙周炎患者龈沟液中甲酸浓度低于对照组，是牙周炎的保护因素，甲酸浓度的倒数对牙周炎患病风险具有良好预测效能；而丙酸和丁酸浓度则升高，是疾病的危险因素，对牙周炎患病风险均具有良好预测价值；三种有机酸浓度随探诊深度而变化，但与牙周炎的分级无明显相关性。
中图分类号:
- R781.42
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