Chapple I L, Garner I, Saxby M S, Moscrop H, Matthews J B
Oral Diseases Research Group, School of Dentistry, University of Birmingham, UK.
J Clin Periodontol. 1999 Mar;26(3):190-8. doi: 10.1034/j.1600-051x.1999.260310.x.
The current study aimed to apply a novel enhanced chemiluminescence assay in the analysis of gingival crevicular fluid (GCF) alkaline phosphatase (ALP) levels from patients with untreated adult periodontitis. 3666 sites in 25 patients were monitored prior to and after attachment loss was detected with a Florida disc probe. Parameters assessed were, relative attachment level, probing pocket depth, occurrence of bleeding on probing (single episode), GCF volume (microliter), total ALP levels (microIU/30 s sample time) and ALP concentration (IU/l). After recruiting patients to the study, all measures were taken at baseline and 3 months later, prior to the institution of non-surgical periodontal therapy at active sites. Thresholds for determining attachment loss were calculated using a modification of the tolerance method. The mesio-buccal sites of all teeth had GCF samples collected. The size of individual patient thresholds used to define whether attachment loss had occurred, was dependent upon the discomfort felt by that patient during electronic probing, with a positive correlation existing between discomfort on probing (10 cm visual analogue scale) and threshold size (R = 0.52, p < 0.049). A total of 274 sites (7.5%) experienced attachment loss of which 39 sites had GCF samples available for analysis. Total ALP levels were significantly higher at baseline for sites that progressed to attachment loss than paired controls (p < 0.003), but all other parameters showed no differences (p > 0.1). There were significant increases in total ALP levels and GCF volumes for active sites between baseline and 3 month measures (p < 0.01), but not for control sites or test site ALP concentration (p > 0.8). The diagnostic accuracy for GCF ALP as a predictor of future attachment loss (threshold 900 microIU/30 s) was 64%, with +ve and -ve predictive values of 62% and 68%. When a threshold of 1300 microIU/30 s was selected for ALP as a marker of recent or currently active disease, diagnostic accuracy and +ve/-ve predictive values were 77% and 77%/76%, respectively. These results indicate that total GCF ALP levels may serve as a predictor of future or current disease activity.
本研究旨在应用一种新型增强化学发光分析法，分析未经治疗的成人牙周炎患者龈沟液（GCF）中碱性磷酸酶（ALP）水平。在使用佛罗里达盘式探针检测附着丧失之前和之后，对25例患者的3666个位点进行了监测。评估的参数包括相对附着水平、探诊袋深度、探诊出血情况（单次发作）、GCF体积（微升）、总ALP水平（微国际单位/30秒采样时间）和ALP浓度（国际单位/升）。在招募患者参加研究后，在基线时以及3个月后、在活动位点进行非手术牙周治疗之前，进行了所有测量。使用改良的耐受方法计算确定附着丧失的阈值。收集了所有牙齿的近中颊侧位点的GCF样本。用于定义是否发生附着丧失的个体患者阈值大小，取决于该患者在电子探诊期间感受到的不适程度，探诊时的不适程度（10厘米视觉模拟量表）与阈值大小之间存在正相关（R = 0.52，p < 0.049）。共有274个位点（7.5%）发生了附着丧失，其中39个位点有可用于分析的GCF样本。进展为附着丧失的位点在基线时的总ALP水平显著高于配对对照（p < 0.003），但所有其他参数均无差异（p > 0.1）。活动位点在基线和3个月测量之间，总ALP水平和GCF体积显著增加（p < 0.01），但对照位点或测试位点的ALP浓度没有增加（p > 0.8）。GCF ALP作为未来附着丧失预测指标（阈值为900微国际单位/30秒）的诊断准确性为64%，阳性和阴性预测值分别为62%和68%。当选择1300微国际单位/30秒作为ALP作为近期或当前活动性疾病标志物的阈值时，诊断准确性以及阳性/阴性预测值分别为77%和77%/76%。这些结果表明，GCF总ALP水平可能作为未来或当前疾病活动的预测指标。
