基质细胞衍生因子1α联合自体贫血小板血浆在恒牙撕脱伤中的应用评价

doi:10.19439/j.sjos.2024.02.012

摘要/Abstract

摘要： 目的: 探讨基质细胞衍生因子1α（SDF-1α）联合自体贫血小板血浆（PPP）在恒牙撕脱伤中的治疗效果。方法: 选择2020年3月—2022年3月衡水市人民医院收治的恒牙撕脱伤患者144例（患牙152颗）,随机分为试验组72例（患牙76颗）和对照组72例（患牙76颗）。对照组行常规再植术,术前使用PPP生物液浸泡、冲洗根尖。试验组在对照组基础上,于离体牙再植前在牙槽窝内植入SDF-1α。术后随访12个月,比较2组植入成功率、术后咬合疼痛程度、龈沟液中炎症因子表达、血清生长因子表达及术后并发症发生率。采用SPSS 19.0软件包对数据进行统计学分析。结果: 对照组患牙再植成功率为90.79%（69/76）,试验组为98.68%（75/76）,试验组显著高于对照组（P<0.05）。术后2 天、3个月和12个月,2组患者疼痛程度评分逐渐降低（P<0.05）;各时间点疼痛程度评分组间比较,差异无统计学意义（P>0.05）。术后1个月,2组患者C反应蛋白（CRP）、白介素6（IL-6）显著降低（P<0.05）,试验组显著低于对照组（P<0.05）;2组患者可溶性细胞间黏附因子（sICAM-1）升高,试验组显著高于对照组（P<0.05）。术后1个月,2组患者血管内皮生长因子（VEGF）、成纤维细胞生长因子（FGF）、转化生长因子β（TGF-β）和血小板衍生生长因子（PDGF）升高,试验组显著高于对照组（P<0.05）。试验组术后并发症发生率显著低于对照组（P<0.05）。结论: PPP联合SDF-1α用于恒牙撕脱伤治疗,延迟再植成功率高,且术后不良反应发生率低。

关键词: 撕脱伤, 恒牙, 贫血小板血浆, 基质细胞衍生因子1α

Abstract: PURPOSE: To explore the therapeutic effect of stromal cell derived factor-1α(SDF-1α) combined with platelet-poor plasma(PPP) on permanent tooth avulsion injury. METHODS: One hundred and forty-four patients with permanent tooth avulsion injuries admitted to Hengshui People's Hospital from March 2020 to March 2022, with a total of 152 affected teeth were included. They were randomly divided into experimental group of 72 cases(76 teeth) and control group of 72 cases(76 teeth). The control group underwent routine replantation surgery, and the root tips were soaked and rinsed with PPP biological solution before surgery. On the basis of the control group, the experimental group implanted SDF-1α into the alveolar fossa before in vitro tooth implantation for treatment. The patients were followed up for 12 months after surgery, the success rate of implantation, degree of postoperative occlusal pain, expression of inflammatory factors in gingival fluid, serum growth factor expression, and incidence of postoperative complications were compared between the two groups. Statistical analysis was performed with SPSS 19.0 software package. RESULTS: The success rate of replantation in the control group was 90.79%(69/76), while the experimental group was 98.68%(75/76). The success rate of replantation in the experimental group was significantly higher than that in the control group(P<0.05). On the 2nd day, 3 months and 12 months after surgery, the pain scores of the two groups of patients gradually decreased (P<0.05). There was no significant difference in pain scores between the two groups at each time point(P>0.05). One month after surgery, the CRP and IL-6 levels in both groups decreased(P<0.05), while the experimental group was significantly lower than the control group(P<0.05). The soluble intercellular adhesion factor (sICAM-1) in both groups increased, and the experimental group was significantly higher than the control group (P<0.05). One month after surgery, vascular endothelial growth factor(VEGF), fibroblast growth factor(FGF), transforming growth factor beta(TGF-β)and platelet derived growth factor(PDGF) were all elevated, and the experimental group was significantly higher than the control group(P<0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group(P<0.05). CONCLUSIONS: The combination of PPP and SDF-1α in treating patients with permanent tooth avulsion injury has a high success rate of delayed replantation and a low incidence of postoperative adverse reactions.

Key words: Avulsion injury, Permanent teeth, Platelet-poor plasma, Stromal cell derived factor-1α

中图分类号:

R782.1

刘琳, 息雪娜, 黄涛, 韩国良. 基质细胞衍生因子1α联合自体贫血小板血浆在恒牙撕脱伤中的应用评价[J]. 上海口腔医学, 2024, 33(2): 175-179.

LIU Lin, XI Xue-na, HUANG Tao, HAN Guo-liang. Effect of stromal cell derived factor-1α combined with autologous platelet poor plasma on avulsion injury of permanent teeth[J]. Shanghai Journal of Stomatology, 2024, 33(2): 175-179.

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