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肾移植术后环孢素 A 和他克莫司治疗的患者中牙龈增生:一项前瞻性研究。

Gingival overgrowth among patients medicated with cyclosporin A and tacrolimus undergoing renal transplantation: a prospective study.

机构信息

Dental School, Department of Stomatology, Division of Periodontics, University of São Paulo, SP, Brazil.

出版信息

J Periodontol. 2011 Feb;82(2):251-8. doi: 10.1902/jop.2010.100368. Epub 2010 Aug 19.

Abstract

BACKGROUND

The aim of this study is to make a longitudinal evaluation of the incidence and severity of gingival overgrowth (GO) induced by immunosuppressive agents, such as tacrolimus (Tcr) and cyclosporin A (CsA), in the absence of calcium channel blockers in patients undergoing renal transplantation (RT).

METHODS

This longitudinal study is conducted in 49 patients with RT who were divided into a CsA group (n = 25) and Tcr group (n = 24). The individuals were assessed at four time intervals: before transplant and 30, 90, and 180 days after RTs. Demographic data and periodontal clinical parameters (plaque index, cemento-enamel junction to the gingival margin, probing depth, clinical attachment level, bleeding on probing [BOP], and GO) were collected at all time intervals.

RESULTS

The mean GO index was significantly lower in the Tcr group compared to the CsA group after 30 (P = 0.03), 90 (P = 0.004), and 180 (P = 0.01) days of immunosuppressive therapy. One hundred eighty days after RTs, a clinically significant GO was observed in 20.0% of individuals in the CsA group and 8.3% of individuals in the Tcr group. However, this difference was not statistically significant (P = 0.41). There was a reduction in periodontal clinical parameters regarding the time of immunosuppressive therapy for PI and BOP (P <0.001) in both groups.

CONCLUSION

Although there was no statistical difference in the incidences of clinically significant GO after 180 days of immunosuppressive therapy, it was observed that GO occurred later in the Tcr group, and the severity of GO in this group was lower than in patients who used CsA.

摘要

背景

本研究旨在评估在肾移植患者中(不使用钙通道阻滞剂),免疫抑制剂如他克莫司(Tcr)和环孢素 A(CsA)引起的牙龈增生(GO)的发生率和严重程度的纵向变化。

方法

本纵向研究纳入了 49 名肾移植患者,分为 CsA 组(n = 25)和 Tcr 组(n = 24)。在四个时间间隔对患者进行评估:移植前和移植后 30、90 和 180 天。在所有时间间隔收集人口统计学数据和牙周临床参数(菌斑指数、牙釉质-牙龈边缘交界处、探诊深度、临床附着水平、探诊出血 [BOP] 和 GO)。

结果

在接受免疫抑制治疗 30、90 和 180 天后,Tcr 组的 GO 指数明显低于 CsA 组(P = 0.03、P = 0.004 和 P = 0.01)。在肾移植后 180 天,CsA 组中有 20.0%的患者和 Tcr 组中有 8.3%的患者出现了临床显著的 GO。然而,这种差异没有统计学意义(P = 0.41)。在两组中,随着免疫抑制治疗时间的延长,牙周临床参数(PI 和 BOP)均有降低(P <0.001)。

结论

尽管在免疫抑制治疗 180 天后,两组患者临床显著 GO 的发生率没有统计学差异,但 Tcr 组 GO 的发生时间较晚,且该组 GO 的严重程度低于使用 CsA 的患者。

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