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义齿性口炎的治疗可改善通过血流介导的血管扩张评估的内皮功能。

Treatment of denture-related stomatitis improves endothelial function assessed by flow-mediated vascular dilation.

作者信息

Osmenda Grzegorz, Maciąg Joanna, Wilk Grzegorz, Maciąg Anna, Nowakowski Daniel, Loster Jolanta, Dembowska Elżbieta, Robertson Douglas, Guzik Tomasz, Cześnikiewicz-Guzik Marta

机构信息

Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland.

Department of Dental Prophylaxis and Experimental Dentistry, Dental School, Jagiellonian University, Krakow, Poland.

出版信息

Arch Med Sci. 2017 Feb 1;13(1):66-74. doi: 10.5114/aoms.2017.64715. Epub 2016 Dec 18.

Abstract

INTRODUCTION

The presence of oral inflammation has recently been linked with the pathogenesis of cardiovascular diseases. While numerous studies have described links between periodontitis and endothelial dysfunction, little is known about the influence of denture-related stomatitis (DRS) on cardiovascular risk. Therefore, the aim of this study was to determine whether the treatment of DRS can lead to improvement of the clinical measures of vascular dysfunction.

MATERIAL AND METHODS

The DRS patients were treated with a local oral antifungal agent for 3 weeks. Blood pressure, flow-mediated dilatation (FMD) and nitroglycerine-mediated vascular dilatation (NMD) were measured during three study visits: before treatment, one day and two months after conclusion of antifungal therapy.

RESULTS

Flow-mediated dilatation measurements showed significant improvement of endothelial function 2 months after treatment (FMD median 5%, 95 CI: 3-8.3 vs. 11%, 95% CI: 8.8-14.4; < 0.01), while there was no difference in control, endothelium-independent vasorelaxations (NMD; median = 15.3%, 95% CI: 10.8-19.3 vs. 12.7%, 95% CI: 10.6-15; = 0.3). Other cardiovascular parameters such as systolic (median = 125 mm Hg; 95% CI: 116-129 vs. 120 mm Hg, 95% CI: 116-126; = 0.1) as well as diastolic blood pressure and heart rate (median = 65.5 bpm, 95% CI: 56.7-77.7 vs. 71 bpm, 95% CI: 66.7-75; = 0.5) did not change during or after the treatment.

CONCLUSIONS

Treatment of DRS is associated with improvement of endothelial function. Since endothelial dysfunction is known to precede the development of severe cardiovascular disorders such as atherosclerosis and hypertension, patients should be more carefully screened for DRS in general dental practice, and immediate DRS treatment should be advised.

摘要

引言

口腔炎症的存在最近被认为与心血管疾病的发病机制有关。虽然许多研究描述了牙周炎与内皮功能障碍之间的联系,但关于义齿性口炎(DRS)对心血管风险的影响却知之甚少。因此,本研究的目的是确定DRS的治疗是否能改善血管功能障碍的临床指标。

材料与方法

DRS患者接受局部口腔抗真菌药物治疗3周。在三次研究访视期间测量血压、血流介导的血管舒张(FMD)和硝酸甘油介导的血管舒张(NMD):治疗前、抗真菌治疗结束后1天和2个月。

结果

治疗2个月后,血流介导的血管舒张测量显示内皮功能有显著改善(FMD中位数5%,95%CI:3-8.3对11%,95%CI:8.8-14.4;P<0.01);而在对照中,非内皮依赖性血管舒张(NMD;中位数=15.3%,95%CI:10.8-19.3对12.7%,95%CI:10.6-15;P = .3)没有差异。其他心血管参数,如收缩压(中位数=125 mmHg;95%CI:116-129对120 mmHg,95%CI:116-126;P = .1)以及舒张压和心率(中位数=65.5次/分钟,95%CI:56.7-77.7对71次/分钟,95%CI:66.7-75;P = .5)在治疗期间或治疗后没有变化。

结论

DRS的治疗与内皮功能的改善有关。由于已知内皮功能障碍先于严重心血管疾病如动脉粥样硬化和高血压之前出现,因此在普通牙科实践中应更仔细地筛查患者是否患有DRS,并建议立即进行DRS治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7819/5206372/9541bf1b1c47/AMS-13-28934-g001.jpg

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