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牙周病与慢性肾脏病患者唾液和龈沟液中人疱疹病毒的检测。

Periodontal disease and detection of human herpesviruses in saliva and gingival crevicular fluid of chronic kidney disease patients.

机构信息

Department of Dentistry, University of Santo Amaro, São Paulo, Brazil.

Department of Medicine, University of Taubate, Taubate, São Paulo, Brazil.

出版信息

J Periodontol. 2020 Sep;91(9):1139-1147. doi: 10.1002/JPER.19-0583. Epub 2020 Feb 26.

Abstract

BACKGROUND

Patients with chronic kidney disease (CKD) have inability to maintain the normal levels of protein metabolism products, blood pressure and hematocrit. Periodontal disease involves an inflammatory destructive process. Identification of opportunistic viruses is extremely important as they are associated with co-morbidities. The objective of this study was to analyse the presence of human herpesviruses in saliva and gingival crevicular fluid (GCF) from patients with CKD.

METHODS

One hundred and thirty one individuals were divided depending on the stage of CKD: Group 1 (clearance of creatinine > 75 mL/min) patients with no renal disease (n = 24); Group 2 (clearance of creatinine of 11-75 mL/min) patients with renal disease (n = 67); Group 3 (clearance of creatinine < 10 mL/min) patients on hemodialysis (n = 40). The parameters of periodontal disease were evaluated. The viral detection was assessed by PCR.

RESULTS

considering the three groups, the prevalence of herpes simplex virus 1 (HSV-1) were 9% in saliva and 5% in GCF; Epstein-Barr virus 36% in saliva and 39% in GCF; human cytomegalovirus (HCMV) 11% in GCF; varicella zoster virus 6% in saliva and 3% in GCF; of human herpesvirus-6 (HHV-6) 6% in saliva and 2% in GCF; and HHV-7 44% in saliva and 8% in GCF. Of these patients, 46.48% presented with severe periodontitis. A statistically significant association between HSV-1 and HCMV was found in hemodialysis patients and severe periodontitis was also more frequent among them.

CONCLUSION

These findings show the importance of evaluating the periodontal disease and detecting herpesviruses in patients with CKD as the inflammatory process observed in these clinical conditions may worsen the course of both periodontal disease and CKD.

摘要

背景

慢性肾脏病(CKD)患者无法维持蛋白质代谢产物、血压和血细胞比容的正常水平。牙周病涉及炎症破坏性过程。鉴定机会性病毒非常重要,因为它们与合并症有关。本研究的目的是分析 CKD 患者唾液和龈沟液(GCF)中人疱疹病毒的存在。

方法

根据 CKD 分期将 131 人分为三组:组 1(肌酐清除率>75 mL/min)无肾脏疾病的患者(n=24);组 2(肌酐清除率为 11-75 mL/min)有肾脏疾病的患者(n=67);组 3(肌酐清除率<10 mL/min)血液透析患者(n=40)。评估牙周病的参数。通过 PCR 评估病毒检测。

结果

考虑到三组,单纯疱疹病毒 1(HSV-1)在唾液中的流行率为 9%,在 GCF 中的流行率为 5%;在唾液中的 EBV 流行率为 36%,在 GCF 中的流行率为 39%;在 GCF 中的人巨细胞病毒(HCMV)流行率为 11%;在唾液中的水痘带状疱疹病毒(VZV)流行率为 6%,在 GCF 中的流行率为 3%;在唾液中的 HHV-6 流行率为 6%,在 GCF 中的流行率为 2%;在唾液中的 HHV-7 流行率为 44%,在 GCF 中的流行率为 8%。这些患者中,46.48%患有严重牙周炎。在血液透析患者中发现 HSV-1 和 HCMV 之间存在统计学显著关联,并且在这些患者中严重牙周炎也更为常见。

结论

这些发现表明,在 CKD 患者中评估牙周病和检测疱疹病毒非常重要,因为在这些临床情况下观察到的炎症过程可能会使牙周病和 CKD 的病程恶化。

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