上海口腔医学

上海口腔医学 ›› 2026, Vol. 35 ›› Issue (4): 399-406.doi: 10.19439/j.sjos.2026.04.009

• 论著 • 上一篇    下一篇

基于既往口腔记录的牙周健康异常表型与2型糖尿病患者心力衰竭相关事件的关联及护理评估意义

史纹纹1, 郭宇飞2, 周盈1, 王杰2, 郭守玉3, 党照华2   

  1. 1.火箭军特色医学中心 口腔科;
    2.心血管内科,北京 100088;
    3.南京医科大学第二附属医院 心血管内科,江苏 南京 210011
  • 收稿日期:2026-03-24 修回日期:2026-05-12 出版日期:2026-08-25 发布日期:2026-09-01
  • 通讯作者: 党照华,E-mail: d18911561218@qq.com
  • 作者简介:史纹纹（1986—）,女,本科,护师,E-mail: sww3470@163.com
  • 基金资助:
    国家卫生健康委医药卫生科技发展研究中心（WKZX2022JG0122）

Association between periodontal abnormality phenotypes based on previous oral records and heart failure-related events in patients with type 2 diabetes mellitus: implications for nursing assessment

Shi Wenwen1, Guo Yufei2, Zhou Ying1, Wang Jie2, Guo Shouyu3, Dang Zhaohua2   

  1. 1. Department of Stomatology;
    2. Department of Cardiovascular Medicine, PLA Rocket Force Characteristic Medical Center. Beijing 100088;
    3. Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanjing Medical University. Nanjing 210011, Jiangsu Province, China
  • Received:2026-03-24 Revised:2026-05-12 Online:2026-08-25 Published:2026-09-01

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摘要： 目的: 探讨基于既往口腔记录的口腔健康异常表型与2型糖尿病（type 2 diabetes mellitus,T2DM）患者随访期间心力衰竭（heart failure,HF）相关事件的关联及对护理评估的意义。方法: 采用单中心回顾性队列研究,纳入120例T2DM患者。依据基线既往口腔检查记录中的牙周袋探诊深度、牙龈出血、口腔卫生指数（oral hygiene index,OHI）、牙菌斑指数（plaque index,PLI）及缺牙情况,将患者分为无明显牙周异常组、牙周袋轻度加深组和牙周袋明显加深组。收集患者一般临床资料、口腔健康指标、炎症指标、血脂及肾功能指标,采用相关分析、Kaplan-Meier法及Cox回归模型分析口腔健康异常表型与HF相关事件的关系。结果: 随访期间,46例患者发生HF相关事件,发生率为38.33%。三组无HF相关事件生存曲线差异有统计学意义（P=0.019）。口腔健康指标与炎症标志物呈正相关,与估算肾小球滤过率（eGFR）呈负相关（P<0.05）。Cox回归分析显示,在未调整模型及年龄调整模型中,口腔健康异常表型分层与HF相关事件存在关联;进一步校正eGFR后,该关联明显减弱,模型估计稳定性不足。敏感性分析显示,在eGFR≥60 mL/(min·1.73 m2)亚组中,口腔健康异常表型分层与HF相关事件之间未观察到稳定关联。结论: 基于既往口腔记录的牙周健康异常表型与T2DM患者HF相关事件之间存在一定相关性,但该关联明显受肾功能状态影响,在校正eGFR后未观察到稳定的独立关联。牙周健康异常表现更可能反映肾功能减退、炎症负荷增加等综合不良状态,可作为慢性病护理综合评估的参考线索,但不能作为HF相关事件的独立预测因素。

关键词: 2型糖尿病, 心力衰竭相关事件, 牙周健康异常, 护理评估

Abstract: PURPOSE: To investigate the association between oral health abnormality phenotypes based on previous oral health records and heart failure(HF)-related events during follow-up in patients with type 2 diabetes mellitus (T2DM), and to explore their implications for nursing assessment. METHODS: A single-center retrospective cohort study was conducted involving 120 patients with T2DM. According to baseline oral examination records, including periodontal pocket probing depth, gingival bleeding, oral hygiene index (OHI), plaque index (PLI), and tooth loss, the patients were classified into three groups: no obvious periodontal abnormality, mild periodontal pocket deepening, and marked periodontal pocket deepening. General clinical data, oral health indicators, inflammatory markers, lipid profiles, and renal function indicators were collected. Correlation analysis, Kaplan-Meier analysis, and Cox proportional hazards regression models were used to evaluate the relationship between oral health abnormality phenotypes and HF-related events. RESULTS: During follow-up, a total of 46 patients developed HF-related events, with an incidence rate of 38.33%. Kaplan-Meier analysis showed a statistically significant difference in HF event-free survival among the three groups(P=0.019). Oral health indicators were positively correlated with inflammatory markers and negatively correlated with estimated glomerular filtration rate (eGFR) (P<0.05). Cox regression analysis showed that oral health abnormality phenotype stratification was associated with HF-related events in the unadjusted model and the age-adjusted model. However, after further adjustment for eGFR, this association was markedly attenuated, and the model estimates became unstable. Sensitivity analysis showed that no stable association was observed between oral health abnormality phenotype stratification and HF-related events in the subgroup with eGFR ≥60 mL/(min·1.73 m2). CONCLUSIONS: Oral health abnormality phenotypes based on previous oral health records showes a potential association with HF-related events in patients with T2DM, but this relationship is substantially influenced by renal function status. Oral health abnormalities may more likely reflect an overall adverse clinical condition characterized by renal impairment, increased inflammatory burden, and metabolic disturbance. Therefore, oral health status may serve as a useful clue for comprehensive nursing assessment in chronic disease management. However, the current evidence is insufficient to support it as a stable independent predictor of HF-related events.

Key words: Type 2 diabetes mellitus, Heart failure-related events, Periodontal health abnormality, Nursing assessment

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