Nylund Karita, Meurman Jukka H, Heikkinen Anna Maria, Honkanen Eero, Vesterinen Maarit, Ruokonen Hellevi
Quintessence Int. 2015 Nov-Dec;46(10):899-907. doi: 10.3290/j.qi.a34698.
Oral and periodontal infection load need to be treated in the predialysis stage among chronic kidney disease (CKD) patients in order to avoid later complications in dialysis or transplantation. Periodontal health was studied by specifically comparing diabetic nephropathy patients with those with other kidney disease.
This descriptive retrospective study comprised 144 predialysis patients (47 women), aged 23 to 83 years, examined at the Helsinki University Hospital, Finland. Of them, 52 (36%) had diabetic nephropathy. Oral and general health data, Periodontal Inflammatory Burden Index (PIBI), and Total Dental Index (TDI) were recorded from hospital records. Results were analyzed with cross tabulation, Pearson chi-square test, and binary logistic regression with Wald test.
Of the diabetic nephropathy patients 39%, and of those with high A1C values 36%, respectively, had two or more sites with probing depths ≥ 6 mm compared with 19% in the other CKD group, and 18% of those with lower A1C values. TDI scores were high among 55% of the diabetic nephropathy patients. A1C values ≥ 6.5% associated with moderate periodontitis in 67%, and elevated PIBI in 62%.
High A1C values associated with high oral infection burden indices. Diabetic nephropathy patients had more often high TDI scores and deep periodontal pockets compared with the other CKD patients.
慢性肾脏病(CKD)患者在透析前阶段需要治疗口腔和牙周感染负荷,以避免透析或移植后期出现并发症。通过将糖尿病肾病患者与其他肾病患者进行具体比较,对牙周健康状况进行了研究。
这项描述性回顾性研究纳入了芬兰赫尔辛基大学医院检查的144例透析前患者(47名女性),年龄在23至83岁之间。其中52例(36%)患有糖尿病肾病。从医院记录中记录口腔和全身健康数据、牙周炎症负担指数(PIBI)和总牙指数(TDI)。结果采用交叉表、Pearson卡方检验和带Wald检验的二元逻辑回归进行分析。
糖尿病肾病患者中,分别有39%的患者和糖化血红蛋白(A1C)值高的患者中有36%的患者有两个或更多探诊深度≥6mm的部位,而其他CKD组为19%,A1C值较低的患者为18%。55%的糖尿病肾病患者TDI评分较高。A1C值≥6.5%与67%的中度牙周炎以及62%的PIBI升高相关。
高A1C值与高口腔感染负担指数相关。与其他CKD患者相比,糖尿病肾病患者TDI评分较高和牙周袋较深的情况更为常见。