Doĝan Başak, Buduneli Eralp, Emingil Gülnur, Atilla Gül, Akilli Azem, Antinheimo Johanna, Lakio Laura, Asikainen Sirkka
Department of Basic Health Sciences, Faculty of Health Education, University of Marmara, Istanbul, Turkey.
J Periodontol. 2005 May;76(5):740-8. doi: 10.1902/jop.2005.76.5.740.
Periodontitis has been linked to increased risk of cardiovascular diseases. Systemic reactions associated with cardiovascular events may depend on characteristics of the subgingival microflora in periodontitis. Our objectives were to compare the numbers of cultivable bacteria, composition of subgingival microflora and clonal distribution of Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) in two groups of patients with generalized chronic periodontitis (GCP), one with an acute myocardial infarction (AMI-GCP) and the other one without AMI (non-AMI-GCP).
In all, 150 dentate individuals were screened for suitability to this study. Subgingival bacterial samples were collected from 11 AMI-GCP and 11 non-AMI-GCP patients who had been selected using strict inclusion criteria in an attempt to exclude confounding factors and to increase comparability of periodontal conditions by matching for periodontal probing depths and attachment levels. Culture methods were used to determine the total viable counts and occurrence and proportions of six periodontal bacterial species and yeasts. Polymerase chain reaction (PCR) technique was used to detect A. actinomycetemcomitans and Porphyromonas gingivalis (P. gingivalis). Intraspecies characterization of A. actinomycetemcomitans included serotyping and genotyping.
The mean proportions of P. gingivalis (P = 0.05) and Tannerella forsythensis (T. forsythensis) (P = 0.01) were significantly lower, but the numbers of Micromonas micros (M. micros) and A. actinomycetemcomitans were up to nine times higher and the mean total number of cultivable bacteria per sample higher (P <0.01) in AMI-GCP than in non-AMI-GCP.
The findings that no target subgingival species were overrepresented but the total bacterial number was higher in AMI-GCP than non-AMI-GCP patients may provide support to the hypothesis that elevated numbers of bacteria in close vicinity to sterile parenteral area present a risk for systemic health.
牙周炎与心血管疾病风险增加有关。与心血管事件相关的全身反应可能取决于牙周炎龈下微生物群的特征。我们的目标是比较两组慢性广泛性牙周炎（GCP）患者的可培养细菌数量、龈下微生物群组成以及伴放线放线杆菌（A. actinomycetemcomitans）的克隆分布，其中一组患有急性心肌梗死（AMI-GCP），另一组未患AMI（非AMI-GCP）。
总共筛选了150名有牙个体是否适合本研究。从11名AMI-GCP患者和11名非AMI-GCP患者中采集龈下细菌样本，这些患者是根据严格的纳入标准选择的，旨在排除混杂因素，并通过匹配牙周探诊深度和附着水平来提高牙周状况的可比性。采用培养方法确定六种牙周细菌种类和酵母菌的总活菌数、出现情况及比例。采用聚合酶链反应（PCR）技术检测伴放线放线杆菌和牙龈卟啉单胞菌（P. gingivalis）。伴放线放线杆菌的种内特征包括血清分型和基因分型。
与非AMI-GCP相比，AMI-GCP中牙龈卟啉单胞菌（P = 0.05）和福赛坦氏菌（T. forsythensis）（P = 0.01）的平均比例显著较低，但微小微单胞菌（M. micros）和伴放线放线杆菌的数量高达9倍，且每个样本的可培养细菌平均总数更高（P <0.01）。
在AMI-GCP患者中未发现目标龈下菌种数量过多，但细菌总数高于非AMI-GCP患者，这一发现可能支持以下假设：无菌注射区域附近细菌数量增加会对全身健康构成风险。
