牙周病治疗对 COPD 结局的影响：系统评价。
Effect of periodontal therapy on COPD outcomes: a systematic review.
机构信息
Department of Oral Surgery, Surgical Implantology and Oral Radiology, School of Health Sciences, School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
Department of Dentistry, 424 General Military Training Hospital, Thessaloniki, Greece.
出版信息
BMC Pulm Med. 2021 Mar 18;21(1):92. doi: 10.1186/s12890-021-01429-2.
BACKGROUND
Latest evidence suggests that periodontitis is prevalent among patients with chronic obstructive pulmonary disease (COPD), while recent studies have also reported a potential benefit of periodontal treatment on several COPD outcomes. This systematic review aims to determine the impact of periodontal treatment on exacerbation rate, lung function and quality of life of COPD patients.
METHODS
A systematic search of electronic databases of PubMed, Scopus, Virtual Health Library, ScienceDirect, Wiley Online Library, Web of Science, ProQuest Dissertation and Theses Global and Google Scholar was conducted. Search restricted to studies involving human subjects which were published from January 2000 to March 2020 in English language. Distiller Systematic Review software was used for data management. Risk of bias was assessed using Risk of Bias 2 (RoB2) and Risk of Bias for non-randomized studies of intervention (ROBINS-I) tools. Overall quality of evidence was judged based on Grading of Recommendations Assessment, Development and Evaluation working group methodology.
RESULTS
Out of 1442 articles retrieved, 7 full text articles were included in the review. Limited evidence suggests that periodontal treatment in patients with COPD and periodontitis is associated with reduced exacerbation frequency and a slower lung function decline rate, while its effects on quality of life remain unclear. In addition, periodontal treatment in COPD is associated with lower hospitalization rates and reduced all-cause mortality. Significant methodological differences were noted amongst included studies, while very low-to-moderate overall quality of evidence was demonstrated.
CONCLUSIONS
Although it is reasonable to advise COPD patients not to neglect their dental health, further studies are warranted to determine the role of periodontal therapy on COPD clinical outcomes.
TRIAL REGISTRATION
PROSPERO 2020 (CRD42020158481). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158481.
背景
最新证据表明，牙周炎在慢性阻塞性肺疾病（COPD）患者中较为普遍，而最近的研究也报告了牙周治疗对 COPD 多种结局的潜在益处。本系统评价旨在确定牙周治疗对 COPD 患者加重率、肺功能和生活质量的影响。
方法
系统检索 PubMed、Scopus、Virtual Health Library、ScienceDirect、Wiley Online Library、Web of Science、ProQuest 学位论文全文库和全球学位论文以及 Google Scholar 电子数据库，检索时间为 2000 年 1 月至 2020 年 3 月，仅限英文文献。限制研究对象为人类，采用 Distiller 系统评价软件进行数据管理。采用风险偏倚评估工具（RoB2 和 ROBINS-I）评估偏倚风险。基于推荐评估、制定与评价（GRADE）工作组的方法，对证据的总体质量进行判断。
结果
从 1442 篇文章中筛选出 7 篇全文纳入本综述。有限的证据表明，COPD 合并牙周炎患者接受牙周治疗与减少加重频率和减缓肺功能下降速度有关，但其对生活质量的影响尚不清楚。此外，COPD 患者接受牙周治疗与降低住院率和减少全因死亡率有关。纳入研究之间存在显著的方法学差异，而总体证据质量为低至中度。
结论
尽管合理建议 COPD 患者不要忽视口腔健康，但仍需要进一步研究来确定牙周治疗对 COPD 临床结局的作用。
试验注册
PROSPERO 2020（CRD42020158481）。https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158481。
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