Faculty of Dentistry, Universidad de Antioquia, Calle 64 52 - 59, Medellin, Antioquia, Colombia.
J Periodontal Res. 2013 Dec;48(6):706-12. doi: 10.1111/jre.12058. Epub 2013 Feb 27.
Periodontitis may alter the systemic condition in patients with diabetes and hence interfere with glycemic control. The objective of this study was to determine the quantifiable changes in glycated hemoglobin (HbA1C) after periodontal non-surgical therapy plus azithromycin in a mixed population of patients with poorly controlled diabetes.
One hundred and five patients were randomized to receive non-surgical therapy plus azythromycin (AZ-Sca =33), non-surgical therapy plus placebo (PB-Sca = 37) and supragingival prophylaxis plus azithromycin (AZ-Pro = 35). Glycated hemoglobin, glycemia and periodontal parameters were measured at baseline, 3, 6 and 9 mo after treatment.
Periodontal parameters were improved in the AZ-Sca and PB-Sca groups as compared to the AZ-Pro group. A greater reduction in probing depth was observed in the AZ-Sca as compared to the PB-Sca group. Improvement in clinical attachment level was similar between AZ-Sca and PB-Sca groups. A reduction from 8.0% to 7.2% (∆0.8%; p < 0.05) in HbA1C was observed in the AZ-Sca at 9 mo as compared to the PB-Sca group in which the reduction was from 7.9% to 7.6% (∆0.3%). There was no decrease in HbA1C in the AZ-Pro group over time. Mean glycemia values decreased from 195 mg/dL to 159.2 mg/dL (∆35.8 mg/dL; p < 0.05) in the AZ-Sca group whereas a decrease from 194 mg/dL to 174.8 mg/dL (∆19.2 mg/dL) in the PB-Sca group at 9 mo was observed. There were no differences between the AZ-Sca and PB-Sca groups for glycemic parameters. No improvement in glycemic values in the AZ-Pro group was observed.
A modest improvement in glycemic control was detected with a trend towards the use of non-surgical therapy plus AZ as compared to the placebo.
牙周炎可能改变糖尿病患者的全身状况，从而干扰血糖控制。本研究的目的是确定在混合糖尿病患者中，牙周非手术治疗联合阿奇霉素治疗后糖化血红蛋白（HbA1C）的可量化变化。
将 105 例患者随机分为接受牙周非手术治疗联合阿奇霉素（AZ-Sca =33）、牙周非手术治疗联合安慰剂（PB-Sca =37）和龈上预防加阿奇霉素（AZ-Pro =35）。在治疗前、治疗后 3、6 和 9 个月测量糖化血红蛋白、血糖和牙周参数。
与 AZ-Pro 组相比，AZ-Sca 和 PB-Sca 组的牙周参数均有所改善。与 PB-Sca 组相比，AZ-Sca 组的探诊深度降低更为显著。AZ-Sca 和 PB-Sca 组的临床附着水平改善相似。与 PB-Sca 组相比，AZ-Sca 组的 HbA1C 从 8.0%降至 7.2%（∆0.8%；p<0.05），而 PB-Sca 组的 HbA1C 从 7.9%降至 7.6%（∆0.3%）。在 AZ-Pro 组中，HbA1C 随时间没有降低。AZ-Sca 组的平均血糖值从 195mg/dL 降至 159.2mg/dL（∆35.8mg/dL；p<0.05），而 PB-Sca 组的血糖值从 194mg/dL 降至 174.8mg/dL（∆19.2mg/dL）。在 AZ-Sca 和 PB-Sca 组之间，血糖参数没有差异。在 AZ-Pro 组中，血糖值没有改善。
与安慰剂相比，牙周非手术治疗联合 AZ 治疗可轻度改善血糖控制，但趋势不明显。
