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非手术牙周治疗可降低难治性高血压患者的心血管风险:一项初步研究。

Non-surgical periodontal treatment reduces cardiovascular risk in refractory hypertensive patients: a pilot study.

机构信息

Estácio de Sá University, Rio de Janeiro, Brazil; Rio de Janeiro State University, Rio de Janeiro, Brazil.

出版信息

J Clin Periodontol. 2013 Jul;40(7):681-7. doi: 10.1111/jcpe.12110. Epub 2013 May 3.

DOI:10.1111/jcpe.12110
PMID:23639076
Abstract

AIM

To evaluate the effects of non-surgical periodontal treatment on left ventricular mass (LVM), arterial stiffness, systolic and diastolic blood pressure and plasma levels of inflammatory markers (C-reactive protein (CRP), fibrinogen and interleukin-6) in refractory hypertension patients.

MATERIAL AND METHODS

This interventional prospective cohort pilot study included 26 patients (53.6 ± 8.0 years old) diagnosed with refractory hypertension and generalized chronic periodontitis. Subjects received non-surgical periodontal treatment according to their needs. Plasma levels of systemic inflammation (CRP; fibrinogen and interleukin-6) and established cardiovascular risk factors [systolic and diastolic blood pressure (SBP and DBP), left ventricular mass (LVM) and arterial stiffness] were assessed at three time points (baseline, 3 months after baseline and 6 months after periodontal therapy).

RESULTS

Periodontal therapy significantly reduced all cardiovascular risk markers evaluated. Median values of SBP and DBP were reduced by 12.5 mmHg and 10.0 mmHg, respectively, whereas left ventricular mass (LVM) reduced by 12.9 g and pulse wave velocity reduced by 0.9 m/s (p < 0.01). Levels of CRP, IL-6 and fibrinogen lowered by 0.5 mg/dl, 1.4 pg/dl and 37.5 mg/dl (p < 0.01), respectively, 6 months after periodontal therapy.

CONCLUSIONS

Periodontal therapy significantly reduced levels of CRP, IL-6, fibrinogen, blood pressure, LVM and arterial stiffness, lowering cardiovascular risk in refractory hypertensive patients.

摘要

目的

评估非手术牙周治疗对左心室质量(LVM)、动脉僵硬度、收缩压和舒张压以及炎症标志物(C 反应蛋白(CRP)、纤维蛋白原和白细胞介素-6)水平的影响在难治性高血压患者中。

材料和方法

这项干预性前瞻性队列研究纳入了 26 名(53.6±8.0 岁)诊断为难治性高血压和广泛性慢性牙周炎的患者。根据需要,为患者提供非手术牙周治疗。在三个时间点(基线、基线后 3 个月和牙周治疗后 6 个月)评估全身炎症水平(CRP;纤维蛋白原和白细胞介素-6)和已建立的心血管危险因素[收缩压和舒张压(SBP 和 DBP)、左心室质量(LVM)和动脉僵硬度]。

结果

牙周治疗显著降低了所有评估的心血管风险标志物。SBP 和 DBP 的中位数分别降低了 12.5mmHg 和 10.0mmHg,而左心室质量(LVM)降低了 12.9g,脉搏波速度降低了 0.9m/s(p<0.01)。牙周治疗 6 个月后,CRP、IL-6 和纤维蛋白原水平分别降低了 0.5mg/dl、1.4pg/dl 和 37.5mg/dl(p<0.01)。

结论

牙周治疗显著降低了 CRP、IL-6、纤维蛋白原、血压、LVM 和动脉僵硬度的水平,降低了难治性高血压患者的心血管风险。

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