López Néstor J, Quintero Antonio, Llancaqueo Marcelo, Jara Lilian
Departamento de Odontología Conservadora, Facultad de Odontología, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2009 Oct;137(10):1315-22.
Studies investigating effects of periodontal treatment (PT) on markers of inflammation in healthy subjects show conflicting results. Few studies have investigated the effects of PT among subjects with coronary heart disease (CHD) risk factors.
To report the results of a pilot prospective study on the effects of periodontal treatment on markers of inflammation among subjects with CHD risk factors.
Seventy three patients aged 53+/-6 years (25% males) with chronic periodontitis, dyslipidemia and other CHD risk factors were subjected to PT consisting on root planning and oral metronidazol and amoxicillin for 7 days. Periodontal clinical parameters, serum C-reactive protein (CRP), fibrinogen levels and erythrocyte sedimentation rate (ESR) were assessed before and at 6 weeks after PT. Polymorphisms at the ILlA-889 and IL1B+3954 genes were also genotyped.
After the treatment period, CRP levels significantly increased from 3.6+/-3.7 mg/ L to 5.4+/-5.7 mg/L (p =0.001). No significant changes were observed in fibrinogen levels and ESR. Higher post-treatment CRP levels were significantly associated with the composite polymorphic genotype at the ILlA-889 and IL1B+3954 genes (p =0.0001), and extensive periodontitis (p =0.005). Moderate alcohol consumption appeared as a protective factor for CRP elevation (p =0.029).
The increase of the CRP levels after PT in patients with CVD risk factors appeared associated with IL-1 gene polymorphisms and extensive periodontitis.
研究调查牙周治疗(PT)对健康受试者炎症标志物的影响,结果相互矛盾。很少有研究调查牙周治疗在有冠心病(CHD)风险因素的受试者中的作用。
报告一项前瞻性试点研究的结果,该研究旨在探讨牙周治疗对有CHD风险因素的受试者炎症标志物的影响。
73例年龄为53±6岁(25%为男性)的慢性牙周炎、血脂异常及其他CHD风险因素患者接受了包括根面平整以及口服甲硝唑和阿莫西林7天的牙周治疗。在牙周治疗前及治疗后6周评估牙周临床参数、血清C反应蛋白(CRP)、纤维蛋白原水平和红细胞沉降率(ESR)。还对IL1A - 889和IL1B + 3954基因的多态性进行了基因分型。
治疗期后,CRP水平从3.6±3.7mg/L显著升高至5.4±5.7mg/L(p = 0.001)。纤维蛋白原水平和ESR未观察到显著变化。治疗后较高的CRP水平与IL1A - 889和IL1B + 3954基因的复合多态基因型显著相关(p = 0.0001),以及与广泛型牙周炎相关(p = 0.005)。适度饮酒似乎是CRP升高的一个保护因素(p = 0.029)。
有心血管疾病风险因素的患者在牙周治疗后CRP水平的升高似乎与IL - 1基因多态性和广泛型牙周炎有关。