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抗感染牙周治疗促进HIV感染全身标志物的改善。

Anti-infective periodontal therapy promoting improvement in systemic markers of HIV infection.

作者信息

Noro Filho Gilberto Araujo, Salgado Daniela Miranda Richarte de Andrade, Casarin Renato Corrêa Viana, Casati Márcio Zaffalon, Costa Claudio, Giovani Elcio Magdalena

机构信息

Division of Special Care in Dentistry, Paulista University, São Paulo, São Paulo, Brazil.

出版信息

AIDS Res Hum Retroviruses. 2013 Jul;29(7):1040-4. doi: 10.1089/aid.2012.0359. Epub 2013 Apr 18.

Abstract

Research supports the theory that the chronic infectious response occurring in periodontal disease may have a role as a risk modifier of systemic diseases. This study assessed the impact of HIV-associated chronic periodontitis treatment on systemic HIV-related markers (CD4 T lymphocytes cell counts and HIV viral load). Fifteen HIV patients presenting chronic periodontitis [at least eight sites presenting a probing depth (PD) >4 mm and bleeding] were included in this study. Patients received full mouth periodontal treatment with an ultrasonic device and supragingival plaque control. Medical (CD4 cell counts and HIV load) as well as periodontal clinical parameters [probing pocket depth (PPD), clinical attachment level (CAL)] were assessed at baseline and 3 and 6 months after treatment. ANOVA/Tukey and Pearson's correlation tests were used for statistical analysis (α=5%). The results showed that PPD reduction and CAL gain were statistically significant at 3 and 6 months after periodontal therapy (p<0.05). At 6 months, CAL gain was 0.6±0.5 mm and PPD reduction was 0.7±0.5 mm. At the same time, a statistically significant increase in CD4 cell counts could be seen after the third month (p<0.05) and sixth month (p<0.05). Moreover, at 6 months, the relationship between the improvement in clinical parameters, i.e., PPD reduction, and the number of TCD4 lymphocytes could be highlighted. This was shown as the greater the PPD reduction, the greater the increase in TCD4 cells (r=0.68, p=0.02). These data suggest that periodontitis treatment could be associated with an improvement in medical conditions in HIV subjects.

摘要

研究支持这样一种理论,即牙周病中发生的慢性感染反应可能作为全身性疾病的风险调节因素发挥作用。本研究评估了与HIV相关的慢性牙周炎治疗对全身性HIV相关标志物(CD4 T淋巴细胞计数和HIV病毒载量)的影响。15名患有慢性牙周炎[至少8个位点探诊深度(PD)>4mm且有出血]的HIV患者纳入本研究。患者接受了使用超声设备的全口牙周治疗和龈上菌斑控制。在基线以及治疗后3个月和6个月评估医学指标(CD4细胞计数和HIV载量)以及牙周临床参数[探诊袋深度(PPD)、临床附着水平(CAL)]。采用方差分析/图基检验和皮尔逊相关性检验进行统计分析(α = 5%)。结果显示,牙周治疗后3个月和6个月时,PPD降低和CAL增加具有统计学意义(p<0.05)。在6个月时,CAL增加为0.6±0.5mm,PPD降低为0.7±0.5mm。同时,在第3个月(p<0.05)和第6个月(p<0.05)后可观察到CD4细胞计数有统计学意义的增加。此外,在6个月时,临床参数的改善即PPD降低与TCD4淋巴细胞数量之间的关系较为突出。表现为PPD降低越大,TCD4细胞增加越多(r = 0.68,p = 0.02)。这些数据表明,牙周炎治疗可能与HIV感染者医疗状况的改善有关。

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