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口腔健康状况与住院期间心肌梗死的发生及临床病程:病例对照研究。

Oral health status and the occurrence and clinical course of myocardial infarction in hospital phase: a case-control study.

机构信息

Faculty of Health Sciences, The Jan Kochanowski University, Kielce, Poland.

出版信息

Cardiol J. 2013;20(4):370-7. doi: 10.5603/CJ.2013.0095.

Abstract

BACKGROUND

Periodontitis may contribute to destabilization of atherosclerotic plaque leading to acute coronary syndrome and myocardial infarction (MI). The aim of the paper was to evaluate the state of the oral cavity and test the association between chosen parameters of acute, hospital phase MI in patients aged 60 and younger.

METHODS

We examined patients with acute MI, age 60. Control group consisted of matched group of patients with stable angina. Patients enrolled in the study underwent dental, cardiovascular and biochemical examination. Left ventricular ejection fraction (LVEF) was measured during echocardiographic examination, intima-media thickness (IMT) was assessed by ultrasonographic examination at the same time.

RESULTS

The case group included 112 hospital patients with acute MI. Patients with acute MI were characterized by higher level of cardiovascular disease risk factors and poor oral health status in comparison to the control group. There was higher prevalence of edentulousness (p = 0.0039) and advanced periodontal disease (APD) (p < 0.0001) in the case group than in the control group. Patients with edentulousness and APD were characterized by the highest levels of fi brinogen, interleukine-6, tumor necrosis factor-a, increased IMT and numerous atherosclerotic plaques. Logistic regression analysis revealed association between biomarkers of myocardial injury, LVEF and chosen periodontal parameter (API, CAL, PDI, BI) and edentulousness.

CONCLUSIONS

Poor oral health status, especially periodontal disease may infl uence on the occurrence and clinical course of MI.

摘要

背景

牙周炎可能导致动脉粥样硬化斑块不稳定,从而导致急性冠状动脉综合征和心肌梗死(MI)。本文的目的是评估口腔状况,并检验在 60 岁以下急性、住院期 MI 患者中选择的参数之间的关联。

方法

我们检查了年龄在 60 岁以下的急性 MI 患者。对照组由稳定型心绞痛的匹配患者组成。研究中纳入的患者接受了牙科、心血管和生化检查。在超声心动图检查期间测量左心室射血分数(LVEF),同时通过超声检查评估内膜-中层厚度(IMT)。

结果

病例组包括 112 名急性 MI 住院患者。与对照组相比,急性 MI 患者具有更高水平的心血管疾病危险因素和较差的口腔健康状况。与对照组相比,病例组的无牙(p = 0.0039)和晚期牙周病(APD)(p < 0.0001)更为常见。无牙和 APD 的患者具有最高水平的纤维蛋白原、白细胞介素-6、肿瘤坏死因子-α、增加的 IMT 和大量的动脉粥样硬化斑块。Logistic 回归分析显示,心肌损伤生物标志物、LVEF 与所选牙周参数(API、CAL、PDI、BI)和无牙之间存在关联。

结论

较差的口腔健康状况,尤其是牙周病,可能会影响 MI 的发生和临床病程。

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