上海口腔医学 ›› 2020, Vol. 29 ›› Issue (4): 390-395.doi: 10.19439/j.sjos.2020.04.011

• 论著 • 上一篇    下一篇

不同分期牙周炎患者骨硬化蛋白表达和细菌分析

刘莞洁, 邹晖, 夏长普, 吴峥嵘, 李朝晖   

  1. 广东省广州市花都区妇幼保健院(胡忠医院),广东医科大学附属广州花都医院 口腔治疗中心 口腔科,广东 广州 510800
  • 收稿日期:2019-12-30 修回日期:2020-04-01 出版日期:2020-08-25 发布日期:2020-09-11
  • 通讯作者: 李朝晖,E-mail:2249513052@qq.com
  • 作者简介:刘莞洁(1985-),女,本科,主治医师,E-mail:yu15808942656@163.com
  • 基金资助:
    广东省省级科技计划项目(2013B021800076)

Analysis of osteosclerotic protein expression and bacterial distribution in periodontitis patients at different stages

LIU Wan-jie, ZOU Hui, XIA Chang-pu, WU Zheng-rong, LI Zhao-hui   

  1. Department of Stomatology,Guangzhou Huadu Maternal and Child Health Hospital (Huzhong Hospital), Guangzhou Medical University. Guangzhou 510800, Guangdong Province, China
  • Received:2019-12-30 Revised:2020-04-01 Online:2020-08-25 Published:2020-09-11

摘要: 目的:探讨不同分期的牙周炎患者骨硬化蛋白水平和细菌分布及骨硬化蛋白与常规牙周检查指标的相关性。方法:选择广州市花都区妇幼保健院2017年3月—2019年6月治疗的牙周炎患者,根据牙周炎严重程度分为Ⅱ期组(n=27)、Ⅲ期组(n=42)和Ⅳ期组(n=22),另选择同期牙周健康者作为对照组(n=30)。在患者治疗前、治疗后3个月分别收集患牙颊面、舌面近中侧位点的龈沟液及菌斑,进行细菌培养,对照组在体检当天进行以上操作。采用酶联免疫吸附法检测龈沟液中骨硬化蛋白表达水平。采用SPSS 23.0软件包分析数据,BI分级与骨硬化蛋白的相关性分析采用Spearman相关系数分析法,PD、CAL与骨硬化蛋白的相关性采用Pearson分析法。结果:治疗前、治疗后Ⅱ期组患者平均PD、平均CAL显著小于Ⅲ期组及Ⅳ期组(P<0.05);治疗前Ⅳ期组平均CAL显著大于Ⅲ期组(P<0.05);治疗后Ⅱ期组、Ⅲ期组、Ⅳ期组平均PD、平均CAL均显著小于本组治疗前(P<0.05);治疗后Ⅲ期组平均PD显著小于Ⅳ期组(P<0.05)。治疗前Ⅱ期组BI分级2级(85.19%)显著高于Ⅲ期组(19.05%)和Ⅳ期组(18.18%)(P<0.05);治疗前Ⅲ期组3级(64.29%)显著高于Ⅱ期组3级(14.81%)(P<0.05)。治疗前Ⅱ期组骨硬化蛋白表达水平显著低于Ⅲ期组及Ⅳ期组(P<0.05),治疗后Ⅱ、Ⅲ、Ⅳ期组骨硬化蛋白表达水平显著低于本组治疗前(P<0.05);治疗后Ⅱ期组骨硬化蛋白表达水平显著低于Ⅲ期组及Ⅳ期组(P<0.05)。不同牙周炎分期患者治疗前、治疗后PD、CAL、BI分级与龈沟液骨硬化蛋白均呈正相关(P<0.05)。Ⅳ期组检出细菌数目大于Ⅲ期组及Ⅱ期组,各期牙周炎患者均以厌氧菌为主,优势菌为牙龈卟啉单胞菌、中间普氏菌、伴放线放线杆菌、核梭杆菌、产黑色素普氏菌。结论:骨硬化蛋白表达水平与牙周炎患者PD、CAL、BI分级密切相关,不同分期牙周炎患者龈沟液、牙菌斑中细菌定植水平不同。检测骨硬化蛋白水平、牙周微生物培养鉴定,有助于对牙周炎严重程度进行评估,为后续治疗方案的选择提供参考。

关键词: 骨硬化蛋白, 细菌培养, 牙周炎

Abstract: PURPOSE: To investigate the osteosclerin level and bacterial distribution in periodontitis patients at different stages, and to analyze the correlation between osteosclerin and the parameters of conventional periodontal examination. METHODS: Patients with periodontitis admitted to Guangzhou Huadu Maternal and Child Health Hospital from March 2017 to June 2019 were selected and divided into stage Ⅱ group (n=27), stage Ⅲ group (n=42) and stage Ⅳ group (n=22) according to the severity of periodontitis; meanwhile, 30 healthy individuals underwent physical examination in our hospital during the same period were selected as control group. Gingival crevicular fluid and plaque at buccal and lingual sites were collected for bacterial culture. The expression of osteosclerotin in gingival crevicular fluid was detected by enzyme-linked immunosorbent assay. The data were processed by SPSS 23.0 software package. Spearman correlation analysis was used to analyze the correlation between BI grade and osteosclerin, and correlation between PD, CAL and osteosclerin was determined by Pearson analysis. RESULTS: The mean PD and mean CAL of patients in stage Ⅱ group before and after treatment were significantly smaller than those in stage Ⅲ and Ⅳ group (P<0.05). The mean CAL of stage Ⅳ group before treatment was significantly greater than that of stage Ⅲ group (P<0.05). After treatment, the mean PD and mean CAL of three groups were all significantly smaller than those before treatment (P<0.05). The mean PD in stage Ⅲ group was significantly lower than that in stage Ⅳ group after treatment (P<0.05). Before treatment, the proportion of BI grade 2 in stage Ⅱ group was significantly higher than that in stage Ⅲ and Ⅳ group (85.19%, 19.05%, 18.18%, P<0.05). Before treatment, the proportion of BI grade 3 in stage Ⅲ group was significantly higher than that in stage Ⅱ group (64.29%, 14.81%, P<0.05). Before the treatment, the expression of osteosclerosis protein in stage Ⅱ group was significantly lower than that in stage Ⅲ and Ⅳ group (P<0.05). The levels of osteosclerin expression of three groups after treatment were all significantly lower than those before treatment (P<0.05). The expression of osteosclerosis protein in stage Ⅱ group was significantly lower than that in stage Ⅲ and Ⅳ group after treatment (P<0.05). PD, CAL and BI of patients with different stages of periodontitis were positively correlated with osclerosin in gingival crevicular fluid before and after treatment (P<0.05). The number of bacteria detected in stage Ⅳ group was significantly higher than that in stage Ⅲ group and stage Ⅱ group. The main bacteria in each group were anaerobic bacteria. The dominant bacteria were Porphyromonas gingivalis, Prevotella intermedia, Actinobacillus actinomycetes, Fusobacterium nucleatum, and Prevotella melaninogenicus. CONCLUSIONS: The expression level of osteosclerosin is closely related to PD, CAL and BI grades in patients with periodontitis, and bacterial colonization levels in gingival crevicular fluid and dental plaque in patients with periodontitis at different stages are different. Detection of osclerosin level and identification of periodontal microorganism culture have high clinical value in clinical diagnosis of periodontitis severity and can provide reference for selection of subsequent treatment plan.

Key words: Osteosclerotin, Bacterial culture, Periodontitis

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