Conway T B, Beck F M, Walters J D
College of Dentistry, The Ohio State University Health Sciences Center, Columbus, USA.
J Periodontol. 2000 Sep;71(9):1448-52. doi: 10.1902/jop.2000.71.9.1448.
Polymorphonuclear leukocytes (PMNs) take up and accumulate ciprofloxacin. This may allow them to enhance the delivery of this agent to the inflamed periodontium.
Cross-sectional and longitudinal approaches were used to test the hypothesis. In the cross-sectional study, 7 periodontally healthy adults and 8 adults with untreated periodontitis were administered three doses of ciprofloxacin (500 mg bid). Gingival fluid (GF) and serum samples were obtained after 28 hours and analyzed by high-performance liquid chromatography (HPLC). In the longitudinal study, 8 adult periodontitis subjects were administered 500 mg ciprofloxacin bid for 8 days. After 28 hours, GF from 4 sites with 5 to 8 mm probing depths was sampled in each subject, serum samples were obtained, and 2 of the 4 sites were root planed. GF and serum were sampled again 7 days later (196 hours after the initial dose).
The mean ciprofloxacin levels in the GF and serum of periodontally healthy subjects were 2.52 +/- 0.22 microg/ml and 0.47 +/- 0.05 microg/ml, respectively. In subjects with periodontitis, these levels were 2.69 +/- 0.44 microg/ml and 0.61 +/- 0.13 microg/ml, respectively. GF ciprofloxacin levels were significantly higher than corresponding serum levels in healthy and diseased subjects (P<0.01), but there were no significant differences in GF or serum levels between the 2 subject groups. Since GF flow was significantly higher at diseased sites, however, more ciprofloxacin was distributed to these sites than to healthy sites. In the longitudinal study, GF flow at 196 hours was 16% lower at root planed sites than at untreated control sites (P = 0.412). The minor decrease in this index of inflammation was accompanied by a small (9%), but statistically significant (P= 0.007), decrease in GF ciprofloxacin levels.
GF ciprofloxacin levels decreased slightly at inflamed periodontal sites after root planing, but were significantly higher than serum levels even at healthy periodontal sites. Inflammation may enhance the distribution of ciprofloxacin to diseased sites, but it is not a major determinant of GF ciprofloxacin levels.
多形核白细胞（PMNs）摄取并积聚环丙沙星。这可能使它们增强该药物向炎症性牙周组织的递送。
采用横断面和纵向研究方法来验证该假设。在横断面研究中，给7名牙周健康成年人和8名未经治疗的牙周炎成年人服用三剂环丙沙星（500毫克，每日两次）。28小时后采集龈沟液（GF）和血清样本，并通过高效液相色谱法（HPLC）进行分析。在纵向研究中，给8名成年牙周炎患者每日两次服用500毫克环丙沙星，共服用8天。28小时后，在每个受试者的4个探诊深度为5至8毫米的部位采集龈沟液，采集血清样本，并对4个部位中的2个进行根面平整。7天后（初始剂量后196小时）再次采集龈沟液和血清样本。
牙周健康受试者龈沟液和血清中环丙沙星的平均水平分别为2.52±0.22微克/毫升和0.47±0.05微克/毫升。在牙周炎患者中，这些水平分别为2.69±0.44微克/毫升和0.61±0.13微克/毫升。健康和患病受试者龈沟液中环丙沙星水平均显著高于相应血清水平（P<0.01），但两组受试者的龈沟液或血清水平无显著差异。然而，由于患病部位的龈沟液流量显著更高，因此与健康部位相比，更多的环丙沙星分布到了这些部位。在纵向研究中，根面平整部位196小时时的龈沟液流量比未治疗的对照部位低16%（P = 0.412）。炎症指标的轻微下降伴随着龈沟液中环丙沙星水平的小幅（9%）但具有统计学意义（P = 0.007）的下降。
根面平整后，炎症性牙周部位的龈沟液中环丙沙星水平略有下降，但即使在健康牙周部位也显著高于血清水平。炎症可能会增强环丙沙星向患病部位的分布，但它不是龈沟液中环丙沙星水平的主要决定因素。
