Elter John R, Hinderliter Alan L, Offenbacher Steven, Beck James D, Caughey Melissa, Brodala Nadine, Madianos Phoebus N
SciMetrika, LLC, Research Triangle Park, NC, USA.
Am Heart J. 2006 Jan;151(1):47. doi: 10.1016/j.ahj.2005.10.002.
Chronic periodontal infection is associated with an increased risk of coronary heart disease. Although the mechanism responsible for the relationship between periodontal disease and cardiovascular events is not fully understood, it is hypothesized that the chronic inflammatory burden of periodontal disease may lead to impaired functioning of the vascular endothelium.
Twenty-two otherwise healthy adults with moderate to severe periodontitis who underwent complete mouth disinfection were evaluated to determine if periodontal therapy would result in improved endothelial function and a decrease in serum inflammatory markers. Subjects had measurements of periodontal disease severity, flow-mediated (endothelium-dependent), and nitroglycerin-mediated (endothelium-independent) dilation of the brachial artery, serum C-reactive protein (CRP) and interleukin 6 (IL-6), and serum total and high-density lipoprotein cholesterol levels on 2 baseline visits separated by 1 month and, again, 1 month after treatment.
There were no significant changes in clinical periodontal measures, flow-mediated dilation, nitroglycerin-mediated dilation, CRP, IL-6, total cholesterol, or high-density lipoprotein cholesterol between the repeated baseline measurements. Periodontal treatment, however, resulted in significant improvements in periodontal pocketing, flow-mediated dilation, and serum IL-6, as well as a trend toward reduction in serum CRP; there were no significant changes in nitroglycerin-mediated dilation or in cholesterol levels.
These results represent proof of concept that improvement in endothelial function, as measured by flow-mediated dilation of the brachial artery, may be possible through near-elimination of chronic oral infection and suggest that the conduct of a larger controlled trial is justified.
慢性牙周感染与冠心病风险增加有关。尽管牙周疾病与心血管事件之间关系的机制尚未完全明了，但据推测，牙周疾病的慢性炎症负荷可能导致血管内皮功能受损。
对22名患有中度至重度牙周炎且接受全口消毒的健康成年人进行评估，以确定牙周治疗是否会改善内皮功能并降低血清炎症标志物水平。受试者在相隔1个月的2次基线访视时，以及治疗后1个月再次测量牙周疾病严重程度、肱动脉的血流介导（内皮依赖性）和硝酸甘油介导（非内皮依赖性）扩张、血清C反应蛋白（CRP）和白细胞介素6（IL-6），以及血清总胆固醇和高密度脂蛋白胆固醇水平。
重复的基线测量之间，临床牙周指标、血流介导扩张、硝酸甘油介导扩张、CRP、IL-6、总胆固醇或高密度脂蛋白胆固醇均无显著变化。然而，牙周治疗使牙周袋深度、血流介导扩张和血清IL-6有显著改善，血清CRP也有降低趋势；硝酸甘油介导扩张或胆固醇水平无显著变化。
这些结果证明了这样一个概念，即通过近乎消除慢性口腔感染，以肱动脉血流介导扩张来衡量的内皮功能改善是可能的，并表明进行更大规模的对照试验是合理的。
