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牙周治疗对慢性肾脏病患者炎症性氧化应激的影响:一项干预性临床试验。

Impact of periodontal treatment on inflammatory oxidative stress in chronic kidney disease subjects: An interventional clinical trial.

作者信息

Maheshwari Suhani, Chahal Gurparkash S, Grover Vishakha, Rathi Manish, Sharma Ravikant, Sharma Rohit, Jain Ashish

机构信息

Private practice, Chandigarh, India.

Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Panjab University, Chandigarh, India.

出版信息

Am J Dent. 2023 Feb;36(1):15-20.

Abstract

PURPOSE

To evaluate the role of improvement in inflammatory oxidative stress by periodontal therapy (NSPT) in chronic kidney disease (CKD) subjects.

METHODS

50 stable subjects of CKD (stage III-IV) and having chronic periodontitis were enrolled for the present study. Group A (control group) subjects who did not receive NSPT and Group B (test group) subjects who received NSPT. Oral hygiene instructions were given to both groups, malondialdehyde (MDA) in gingival crevicular fluid (GCF) and serum, albumin creatinine ratio (ACR), urine protein creatinine ratio (UPCR), pocket depth (PD), clinical attachment loss (CAL), plaque index (PI), gingival index (GI), Interleukin 1-beta (IL-1β), high sensitivity C-reactive protein (hs-CRP) in serum were assessed at baseline and 6 months.

RESULTS

There was a significant difference observed in PD, CAL, PI, GI and MDA-GCF, hs-CRP, IL-1β in serum following NSPT in the test group compared to the control group at 6 months follow up. Within the limitations of the study, the results revealed that NSPT can be used as an effective method to reduce inflammatory oxidative stress in CKD subjects and improve renal health. Further well-designed longitudinal trials with larger sample size and longer follow ups are needed.

CLINICAL SIGNIFICANCE

The non-surgical periodontal intervention showed statistically significant improvement on oxidative and inflammatory stress markers in gingival crevicular fluid and serum in subjects suffering from chronic kidney disease which suggests that periodontal treatment may be beneficial for these subjects.

摘要

目的

评估牙周治疗(非手术牙周治疗,NSPT)改善慢性肾脏病(CKD)患者炎症性氧化应激的作用。

方法

本研究纳入50例稳定的CKD(Ⅲ - Ⅳ期)且患有慢性牙周炎的患者。A组(对照组)患者未接受NSPT,B组(试验组)患者接受NSPT。两组均给予口腔卫生指导,在基线和6个月时评估龈沟液(GCF)和血清中的丙二醛(MDA)、白蛋白肌酐比值(ACR)、尿蛋白肌酐比值(UPCR)、牙周袋深度(PD)、临床附着丧失(CAL)、菌斑指数(PI)、牙龈指数(GI)、血清白细胞介素1β(IL - 1β)、高敏C反应蛋白(hs - CRP)。

结果

在6个月随访时,试验组接受NSPT后,与对照组相比,PD、CAL、PI、GI以及血清中的MDA - GCF、hs - CRP、IL - 1β有显著差异。在本研究的局限性范围内,结果显示NSPT可作为降低CKD患者炎症性氧化应激和改善肾脏健康的有效方法。需要进一步进行设计更完善、样本量更大且随访时间更长的纵向试验。

临床意义

非手术牙周干预对慢性肾脏病患者龈沟液和血清中的氧化应激和炎症应激标志物有统计学上的显著改善,这表明牙周治疗可能对这些患者有益。

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