北京大学学报(医学版) ›› 2013, Vol. 45 ›› Issue (6): 979-983.

• 论著 • 上一篇    下一篇

牙周保健行为及认知水平对2型糖尿病患者牙周健康和血糖代谢的影响

李峥1,沙月琴2△,朱凌3△ ,张博学3,徐菁玲1   

  1. (1. 北京大学第三医院口腔科,北京100191;2. 北京大学口腔医学院·口腔医院牙周科,北京 100081;3. 北京大学口腔医学院·口腔医院预防科,北京100081)
  • 出版日期:2013-12-18 发布日期:2013-12-18

Effects of dental health awareness and behaviours on the glycemic metabolic characteristics and periodontal disease of patients with type 2 diabetic

LI Zheng1, SHA Yue-qin2△, ZHU Ling3△, ZHANG Bo-xue3 , XU Jing-ling1   

  1. (1.Depatment of Stomatology, Peking University Third Hospital, Beijing 100191, China; 2. Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081,China; 3. Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China)
  • Online:2013-12-18 Published:2013-12-18

摘要: 目的:分析2型糖尿病与慢性牙周炎的双向作用关系及影响因素。方法:对83名2型糖尿病患者进行牙周检查、血糖代谢检测及问卷调查。结果:83名2型糖尿病患者中、重度牙周炎患病率为67.5%,与轻度牙周炎个体相比,其牙周炎症程度及附着丧失水平受糖化血红蛋白(glycosylated hemoglobin A1,HbA1C)水平≥8.0%(OR=54.1~143.1)、服用降糖药(OR=12.9~44.6)、生活压力大(OR=16.9~29.6)、对糖尿病治疗状况不满意(OR=16.9~18.0)、牙周保健知识水平低(OR=3.4)、年龄大(OR=1.1)、不能正确进行牙龈炎症判断(OR=13.3)等因素影响,与此同时,患中、重度牙周炎(OR=8.61),刷牙效果差(OR=8.07),不了解菌斑(OR=7.49)的个体HbA1C水平更易控制不良(≥8.0%)。结论:牙周炎严重程度与HbA1C 水平存在双向影响关系,口腔卫生行为及其认知水平在其间发挥协同作用。

关键词: 糖尿病, 2型, 牙周炎, 口腔保健, 健康知识, 态度, 实践

Abstract: To analyze the effects of dental health awareness and behaviours on the relationship between glycemic metabolic characteristics and periodontal disease of type 2 diabetic patients. Methods: In the study, 83 subjects with type 2 diabetes mellitus were recruited. The clinical periodontal indexes, such as pocket probing depth (PPD), attachment loss (AL), modified bleeding index (mBI), plaque index (PLI) were obtained with a Williams type periodontal probe; Laboratory examinations including glycosylated haemoglobin A1(HbA1C) were made, glucose assay tested, and the structured questionnaire interview conducted evaluationg the knowledge, attitude and practice (KAP) about periodontal health. Results: The prevalence of moderate and severe periodontitis was 67.5%, compared with mild periodontitis, whose severities were affected by the higher level of HbA1C (≥8.0%) (OR 54.1-143.1), followed by using glycemic drug (OR=12.9-44.6), stress (OR=16.9-29.6), and the dissatisfaction with diabetic therapy (OR=16.9-18.0) et al. Meanwhile the attachment loss conditions were also correlated with the poor periodontal knowledge level(OR=3.4),older age(OR=1.1),and misjudgement of gingival inflammation (OR=13.3) et al. On the other hand, individuals with moderate and severe periodontitis, having bad teeth brushing effects and knowing about dental plaque inadequately, had a significantly higher risk for the poorly controlled glycemic results (HbA1C≥8.0%), and the OR was 8.61, 8.07, and 7.49 respectively. Conclusion: In patients with type 2 diabetes the severity of periodontal disease and the glycemic metabolic level (HbA1C) have a definite bidirectional adverse interrelationship, which is affected by the dental health awareness and behaviours.

Key words: Diabetes mellitus, type 2, Periodontitis, Oral health, Health knowledge, attitudes, practice

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