应激性唾液标志物与牙周炎临床参数的相关性分析

doi:10.19439/j.sjos.2020.01.019

摘要/Abstract

摘要： 目的：探讨应激性唾液标志物嗜铬粒蛋白A（chromogranin A,CgA）、皮质醇、α淀粉酶、β内啡肽与牙周炎临床参数龈沟出血指数（sulcus bleeding index,SBI）、牙周探诊深度（periodontal probing depth,PD）、附着丧失（attachment loss,AL）的相关性。方法：选择2017年12月—2018年12月江西省中西医结合医院口腔科收治的慢性牙周炎患者105例为牙周炎组,同期在院健康体检者105例为对照组,检测2组唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平及SBI、PD、AL。采用SPSS 22.0软件包分析应激性唾液标志物与牙周炎临床参数的相关性,利用多因素Logistic回归分析明确牙周炎有关的危险因素。结果：牙周炎组唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平显著高于对照组(P<0.05),牙周炎组SBI、PD、AL显著高于对照组(P<0.05),唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平与SBI均呈正相关 (P<0.05）,唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平与PD均呈正相关 (P<0.05）,唾液中CgA、皮质醇、α淀粉酶、β内啡肽水平与AL均呈正相关 (P<0.05）,CgA、皮质醇、α淀粉酶、β内啡肽是牙周炎的独立危险因素(P<0.05)。结论：应激性唾液标志物CgA、皮质醇、α淀粉酶、β内啡肽与牙周炎临床参数显著相关,提示应激性唾液标志物能在一定程度上反映牙周炎的病情进展,为牙周炎诊断和疗效监测提供有益参考。

关键词: 嗜铬粒蛋白A, 皮质醇, α淀粉酶, β内啡肽, 牙周炎, 相关性

Abstract: PURPOSE: To investigate the correlation between salivary stress markers chromogranin A (CgA), cortisol, α-amylase, β-endorphin and clinical parameters of periodontitis, including sulcus bleeding index (SBI), periodontal probing depth (PD) and attachment loss (AL). METHODS: A total of 105 patients with chronic periodontitis (periodontitis group) and 105 healthy individuals (control group) visiting our hospital from December 2017 to December 2018 were selected. Indicators including CgA, cortisol, α-amylase, β-endorphin levels, SBI, PD, and AL were detected in both groups, and the correlation among them was determined by Pearson's analysis, multivariate logistic regression was used to analyze the risk factors associated with periodontitis using SPSS 22.0 software package. RESULTS: The levels of CgA, cortisol, α-amylase and β-endorphin in the periodontitis group were significantly higher than those in the control group (P<; 0.05). SBI, PD and AL in the periodontitis group were significantly higher than those in the control group (P<; 0.05). The levels of CgA, cortisol, α-amylase and β-endorphin in saliva were positively correlated with SBI, PD, and AL (P<; 0.05). CgA, cortisol, α-amylase, and β-endorphin were independent risk factors for periodontitis (P<; 0.05). CONCLUSIONS: Salivary stress markers CgA, cortisol, α-amylase, and β-endorphin are significantly associated with clinical parameters of periodontitis, suggesting that they can reflect the progression of periodontitis, thus providing an effective reference for diagnosis and efficacy monitoring of periodontitis.

Key words: Chromogranin A, Cortisol, α-amylase, β-endorphin, Periodontitis, Correlation

中图分类号:

R781.4

余勤, 胡飞, 朱焘. 应激性唾液标志物与牙周炎临床参数的相关性分析[J]. 上海口腔医学, 2020, 29(1): 93-96.

YU Qin, HU Fei, ZHU Tao. Correlation between salivary stress markers and clinical parameters of periodontitis[J]. Shanghai Journal of Stomatology, 2020, 29(1): 93-96.

参考文献

[1] 吴迪, 刘凡, 陈宏瑞, 等. 慢性牙周炎患者口腔健康相关生命质量的影响因素分析[J]. 中国实用护理杂志, 2017, 33(9): 682-690.
[2] 喻爱霞. 牙周炎患者应用牙周组织再生术联合正畸治疗的临床效果评价[J]. 河北医科大学学报, 2017, 38(3): 306-310.
[3] 姚霜, 刘晓君, 周治, 等. 咬合调整对牙周炎正畸治疗患者牙周状况的影响[J]. 国际口腔医学杂志, 2017, 9(1): 50-54.
[4] Albandar JM.Underestimation of periodontitis in NHANES surveys[J]. J Periodontol, 2017, 82(3): 337-341.
[5] 李居武, 夏宣童, 饶红艺. 牙周炎患者血清及龈沟液中多项炎性细胞因子的变化观察[J]. 川北医学院学报, 2015, 13(3): 340-343.
[6] Rai B, Kaur J, Anand SC, et al.Salivary stress markers, stress, and periodontitis: a pilot study[J]. J Periodontol, 2011, 82(2): 287-292.
[7] 成祥, 赵名, 林松,等. 长航应激对潜艇艇员交感-肾上腺髓质轴功能的影响[J]. 军事医学, 2015, 39(4): 245-249.
[8] Toda M, Den R, Hasegawa-Ohira M, et al.Effects of woodland walking on salivary stress markers cortisol and chromogranin A[J]. Complement Ther Med, 2013, 21(1): 29-34.
[9] Naruishi K, Nagata T.Biological effects of interleukin-6 on gingival fibroblasts: Cytokine regulation in periodontitis[J]. J Cell Physiol, 2018, 233(9): 6393-6400.
[10] 刘林林, 苏文君, 蒋春雷. 唾液应激生理指标研究进展[J]. 临床军医杂志, 2017, 45(11): 1204-1208.
[11] 张懿, 苏文君, 蒋春雷. 应激生理指标皮质醇和 α淀粉酶的研究进展[J]. 军事医学, 2017, 22(2): 135-139.
[12] Hlavacova N, Solarikova P, Marko M, et al.Blunted cortisol response to psychosocial stress in atopic patients is associated with decrease in salivary alpha-amylase and aldosterone: Focus on sex and menstrual cycle phase[J]. Psychoneuroendocrinology, 2017, 78: 31-38.
[13] Huang Y, Liu Z, Liu W, et al.Short communication: Salivary haptoglobin and chromogranin A as non-invasive markers during restraint stress in pigs[J]. Res Vet Sci, 2017, 114: 27-30.
[14] Mccullough JEM, Liddle SD, Close C, et al.Reflexology: A randomised controlled trial investigating the effects on beta-endorphin, cortisol and pregnancy related stress[J]. Complement Ther Clin Pract, 2018, 31: 76-84.
[15] Qiu J, Jiang YF, Li F, et al.Effect of combined music and touch intervention on pain response and β-endorphin and cortisol concentrations in late preterm infants[J]. BMC Pediatr, 2017, 17(1): 38-41.