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随机对照试验牙周治疗对稳定型冠状动脉疾病患者心血管风险生物标志物的影响:3 个月的初步发现。

Randomized controlled trial of the effect of periodontal treatment on cardiovascular risk biomarkers in patients with stable coronary artery disease: Preliminary findings of 3 months.

机构信息

Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

Cardiology Division, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

出版信息

J Clin Periodontol. 2019 Mar;46(3):321-331. doi: 10.1111/jcpe.13085. Epub 2019 Mar 6.

Abstract

AIM

To assess the effect of periodontal therapy (PT) on cardiovascular blood biomarkers.

MATERIALS AND METHODS

This single-blind, parallel-design, randomized controlled trial included patients with stable coronary artery disease and periodontitis. The test group (TG) received non-surgical PT, whereas the control group (CG) received one session of plaque removal. Plasma levels of C-reactive protein (CRP), glycated haemoglobin, lipids and cytokines (IL-1β, IL-6, IL-8, IL-10, IFN-γ and TNF-α) were measured at baseline and after 3 months.

RESULTS

Eighty-two patients (74.4% women, mean age 59.6 years) were analysed. TG had significantly better periodontal parameters than CG after 3 months, but no significant differences in blood markers were observed between them. In a post hoc subgroup analysis in patients with baseline CRP <3 mg/L, a significant increase in CRP was observed in CG (1.44 ± 0.82 mg/L to 4.35 ± 7.85 mg/L, p = 0.01), whereas CRP remained unchanged in TG (1.40 ± 0.96 mg/L to 1.33 ± 1.26 mg/L, p = 0.85), resulting in a significant difference between groups at 3 months. In patients with CRP ≥3 mg/L, a significant reduction in CRP was observed only in TG (11.3 ± 12.8 mg/L to 5.7 ± 4.1 mg/L, p = 0.04). Levels of IL-6 and IL-8 were significantly lower in TG than CG at 3 months.

CONCLUSIONS

PT leads to lower levels of CRP, IL-6 and IL-8 in cardiovascular patients with high CRP levels.

摘要

目的

评估牙周治疗(PT)对心血管血液生物标志物的影响。

材料和方法

这是一项单盲、平行设计、随机对照试验,纳入了患有稳定型冠状动脉疾病和牙周炎的患者。试验组(TG)接受非手术 PT,而对照组(CG)接受一次菌斑去除。在基线和 3 个月后测量血浆 C 反应蛋白(CRP)、糖化血红蛋白、脂质和细胞因子(IL-1β、IL-6、IL-8、IL-10、IFN-γ 和 TNF-α)水平。

结果

分析了 82 名患者(74.4%为女性,平均年龄 59.6 岁)。TG 在 3 个月后牙周参数明显优于 CG,但两组间血液标志物无显著差异。在基线 CRP<3mg/L 的患者亚组分析中,CG 的 CRP 显著升高(1.44±0.82mg/L 至 4.35±7.85mg/L,p=0.01),而 TG 的 CRP 无变化(1.40±0.96mg/L 至 1.33±1.26mg/L,p=0.85),3 个月时两组间有显著差异。在 CRP≥3mg/L 的患者中,仅在 TG 中观察到 CRP 显著降低(11.3±12.8mg/L 至 5.7±4.1mg/L,p=0.04)。TG 在 3 个月时的 CRP、IL-6 和 IL-8 水平均显著低于 CG。

结论

在 CRP 水平较高的心血管病患者中,PT 可降低 CRP、IL-6 和 IL-8 的水平。

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