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对接受生物疗法治疗的波兰类风湿性关节炎患者的牙周状况分析。

Analysis of periodontal status in Polish patients with rheumatoid arthritis treated with biological therapies.

作者信息

Samborska-Mazur Joanna, Sikorska Dorota, Wyganowska Marzena Liliana

机构信息

Private Dental Practice Joanna Samborska, Poznan, Poland.

Department of Rheumatology, Rehabilitation and Internal Medicine, Poznan University of Medical Sciences, Poland.

出版信息

Reumatologia. 2024;62(5):351-359. doi: 10.5114/reum/194593. Epub 2024 Nov 9.

Abstract

INTRODUCTION

Periodontitis, characterized by inflammation affecting the tooth-supporting tissues, may increase the risk of rheumatoid arthritis (RA) or cardiovascular diseases. The aim of the study was to evaluate the periodontal status in RA patients and its impact on the inflammatory markers and red cell parameters obtained from complete blood laboratory tests to study the risk of cardiovascular disease development.

MATERIAL AND METHODS

The cross-sectional study included 50 patients with RA treated with biological therapies: tumor necrosis factor inhibitors, interleukin-6 blockers. Rheumatoid arthritis disease activity was assessed with Disease Activity Score with 28-joint count (DAS28). The periodontal indices modified Approximal Periodontal Index, modified Papillary Bleeding Index, and Periodontal Screening Index (PSI) were used to assess patients' periodontal status. Serum levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used as inflammatory markers and a potential cardiovascular risk factor.

RESULTS

No statistically significant correlation was found between the periodontal status and RA activity. However, a statistically significant correlation was found between the CRP results and the PSI scores ( = -0.264510, = 0.048837). Evaluation of the red cell parameters showed statistically significant differences in the markers of inflammation ESR ( = 0.369398, = 0.008289) and CRP ( = 0.367405, = 0.008672). Red cell distribution width values were also correlated with RA activity ( = 0.286387, = 0.043769) and duration of the disease ( = 0.339425, = 0.015889).

CONCLUSIONS

A satisfactory periodontal status was found in most of the study group. Increased CRP levels in patients with periodontitis may indicate the negative impact of periodontal status on the general clinical condition of the patient.

摘要

引言

牙周炎以影响牙齿支持组织的炎症为特征,可能会增加类风湿关节炎(RA)或心血管疾病的风险。本研究的目的是评估RA患者的牙周状况及其对全血实验室检查中炎症标志物和红细胞参数的影响,以研究心血管疾病发生的风险。

材料与方法

这项横断面研究纳入了50例接受生物疗法治疗的RA患者:肿瘤坏死因子抑制剂、白细胞介素-6阻滞剂。采用28个关节计数的疾病活动评分(DAS28)评估类风湿关节炎疾病活动度。使用改良近中牙周指数、改良牙龈出血指数和牙周筛查指数(PSI)来评估患者的牙周状况。血清红细胞沉降率(ESR)和C反应蛋白(CRP)水平用作炎症标志物和潜在的心血管危险因素。

结果

未发现牙周状况与RA活动度之间存在统计学显著相关性。然而,发现CRP结果与PSI评分之间存在统计学显著相关性(=-0.264510,=0.048837)。对红细胞参数的评估显示,炎症标志物ESR(=0.369398,=0.008289)和CRP(=0.367405,=0.008672)存在统计学显著差异。红细胞分布宽度值也与RA活动度(=0.286387,=0.043769)和疾病持续时间(=0.339425,=0.015889)相关。

结论

在大多数研究组中发现牙周状况良好。牙周炎患者CRP水平升高可能表明牙周状况对患者总体临床状况有负面影响。

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Predicting best treatment in rheumatoid arthritis.预测类风湿关节炎的最佳治疗方法。
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