Ellis J S, Seymour R A, Steele J G, Robertson P, Butler T J, Thomason J M
Department of Restorative Dentistry, The Dental School, University of Newcastle upon Tyne, England, UK.
J Periodontol. 1999 Jan;70(1):63-7. doi: 10.1902/jop.1999.70.1.63.
The prevalence of gingival overgrowth induced by chronic medication with calcium channel blockers is uncertain. Although there have been several studies examining this question, the results are conflicting, with previous estimates ranging from 20% to 83%. There have been only 2 studies examining the prevalence of overgrowth induced by diltiazem and amlodipine, with estimates of 74% and 3.3%, respectively.
The current study aimed to address the problems associated with these studies by examining a sample of patients taking one of 3 calcium channel blockers, who were drawn from a community-based population in northeastern England. Nine hundred eleven (911) subjects were recruited from general medical practices in the area. Of these, 442 were taking nifedipine, 181 amlodipine, and 186 diltiazem. In addition, 102 control subjects were examined. Drug and demographic data for each subject were recorded. The periodontal condition of all subjects was assessed including plaque index, papillary bleeding index, and a photograph of the anterior gingivae for subsequent analysis of overgrowth severity.
More than six percent (6.3%) of subjects taking nifedipine were seen to have significant overgrowth. This overgrowth was statistically greater than the amount of overgrowth seen in either of the other 2 drug groups or the control population. The prevalence of gingival overgrowth induced by amlodipine or diltiazem was not statistically significant when compared to the control group. The severity of overgrowth within the nifedipine group was found to be related to the amount of gingival inflammation and also to the gender of the subject, with males being 3 times as likely to develop overgrowth than females.
The prevalence of clinically significant overgrowth related to chronic medication with calcium channel blockers is low, i.e., 6.3% for nifedipine. Males are 3 times as likely as females to develop clinically significant overgrowth. The presence of gingival inflammation is an important cofactor for the expression of this effect.
长期使用钙通道阻滞剂导致牙龈增生的患病率尚不确定。尽管已有多项研究探讨此问题，但结果相互矛盾，先前的估计范围为20%至83%。仅有两项研究考察了地尔硫䓬和氨氯地平所致牙龈增生的患病率，估计分别为74%和3.3%。
本研究旨在通过对服用三种钙通道阻滞剂之一的患者样本进行检查，解决这些研究中存在的问题，这些患者来自英格兰东北部的社区人群。从该地区的普通医疗诊所招募了911名受试者。其中，442人服用硝苯地平，181人服用氨氯地平，186人服用地尔硫䓬。此外，检查了102名对照受试者。记录了每个受试者的药物和人口统计学数据。评估了所有受试者的牙周状况，包括菌斑指数、龈乳头出血指数，并拍摄了前牙牙龈照片，以便随后分析增生严重程度。
服用硝苯地平的受试者中有超过6.3%出现明显增生。这种增生在统计学上显著高于其他两个药物组或对照组中观察到的增生量。与对照组相比，氨氯地平或地尔硫䓬所致牙龈增生的患病率无统计学意义。发现硝苯地平组内增生的严重程度与牙龈炎症程度以及受试者性别有关，男性发生增生的可能性是女性的3倍。
与长期使用钙通道阻滞剂相关的具有临床意义的增生患病率较低，即硝苯地平为6.3%。男性发生具有临床意义增生的可能性是女性的3倍。牙龈炎症的存在是这种效应表达的重要协同因素。
