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牙周病治疗可抑制牙周炎患者的血小板活化:一项对照随机干预试验。

Periodontal treatment limits platelet activation in patients with periodontitis-a controlled-randomized intervention trial.

机构信息

Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria.

Department for Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria.

出版信息

J Clin Periodontol. 2018 Sep;45(9):1090-1097. doi: 10.1111/jcpe.12980. Epub 2018 Aug 1.

Abstract

AIM

Periodontitis results in platelet activation and enhanced risk for cardiovascular disease. As it is currently unknown whether periodontal treatment reverses platelet hyper-reactivity, we aimed to investigate the role of periodontal treatment on platelet activation.

MATERIALS AND METHODS

In a prospective controlled therapeutic trial, 52 patients were enrolled and randomly selected for periodontal treatment or monitored without treatment for 3 months. Patient blood was analysed by flow cytometry for platelet activation markers and by light transmission aggregometry for platelet aggregation in response to pro-thrombotic stimuli.

RESULTS

In this study, platelet activation in the control group aggravated over the observation period of 3 months, whereas patients that underwent periodontal treatment showed unchanged levels of platelet activation, measured by surface expression of CD62P, CD40L, generation of reactive oxygen production, activation of GPIIb/IIIa and fibrinogen binding. Moreover, platelet turnover, measured by platelet RNA content and platelet aggregation in response to collagen, differed significantly between patients that were treated and those who were untreated.

CONCLUSIONS

Subgingival debridement reduces the risk of aggravated platelet activation and therefore might potentially diminish subsequent diseases such as cardiovascular disease in periodontal patients.

摘要

目的

牙周炎可导致血小板活化,增加心血管疾病风险。由于目前尚不清楚牙周治疗是否可逆转血小板高反应性,我们旨在研究牙周治疗对血小板活化的作用。

材料和方法

在一项前瞻性对照治疗试验中,招募了 52 名患者,并随机选择进行牙周治疗或不治疗 3 个月进行监测。通过流式细胞术分析患者血液中的血小板活化标志物,通过比浊法分析血小板对促血栓形成刺激物的聚集反应。

结果

在这项研究中,对照组的血小板活化在 3 个月的观察期内加重,而接受牙周治疗的患者的血小板活化水平保持不变,通过 CD62P、CD40L 的表面表达、活性氧生成、GPIIb/IIIa 激活和纤维蛋白原结合来测量。此外,通过血小板 RNA 含量和胶原诱导的血小板聚集来测量的血小板更新,在接受治疗和未接受治疗的患者之间存在显著差异。

结论

龈下刮治可降低血小板活化加重的风险,从而可能降低牙周病患者随后发生心血管疾病等疾病的风险。

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