Eley B M, Cox S W
Periodontal Department, King's College School of Medicine & Dentistry, Denmark Hill, London, UK.
J Clin Periodontol. 1996 Jul;23(7):681-92. doi: 10.1111/j.1600-051x.1996.tb00594.x.
The purpose of this study is to determine whether gingival crevicular fluid (GCF) elastase total activity (TA) and concentration (EC) correlate with and predict progressive attachment loss (AL). 75 previously untreated patients with moderate periodontitis were recruited. GCF was collected from 16 molar and premolar mesiobuccal sites and probing attachment loss (PAL), probing depth (PPD), gingival index (GI), gingival bleeding index (GBI) and plaque index (Pl.I) were measured. PAL and PPD were measured with an electronic, constant pressure probe. Patients were given basic periodontal treatment prior to baseline when the above procedures were repeated. In addition, carefully localised radiographs were taken of the test teeth and repeated annually. Patients were seen at 3 months intervals to 2 years and the procedures were repeated. 119 AL sites were detected and 89 of these were rapid AL sites (RAL) and 30 were gradual AL sites (GAL). Elastase levels (TA & EC) at RAL sites were significantly higher (p < or = 0.0001) than paired control sites in the same patient at both the attachment loss time (ALT) and the prediction time (PT). The mean levels (TA & EC) over the study period at GAL sites were significantly higher (p < or = 0.0001) than paired control sites in the same patient. Using a critical value (CV) of 125 micronsU/30 s (TA) and 400 micronsU/micronsL (EC) in 2 x 2 contingency tables showed a sensitivity of 100% and specificity of 99.95% (TA) and a sensitivity of 100% and specificity of 99.91% (EC) at the PT with very similar values at the ALT. Patient level comparisons showed that the mean elastase levels (TA & EC) were significantly higher (p < or = 0.0001) at RAL and GAL sites than non-attachment loss (NAL) sites in AL patients and that the mean levels were significantly higher (p < or = 0.0001) in AL patients than NAL patients. All these results indicate that these CVs for GCF elastase activity may serve as a predictors of future attachment loss.
本研究的目的是确定龈沟液（GCF）弹性蛋白酶总活性（TA）和浓度（EC）是否与进行性附着丧失（AL）相关并可预测该情况。招募了75例既往未接受治疗的中度牙周炎患者。从16个磨牙和前磨牙的近中颊侧位点采集龈沟液，并测量探诊附着丧失（PAL）、探诊深度（PPD）、牙龈指数（GI）、牙龈出血指数（GBI）和菌斑指数（Pl.I）。使用电子恒压探针测量PAL和PPD。在基线时重复上述操作之前，先对患者进行基础牙周治疗。此外，对受试牙齿拍摄仔细定位的X光片，并每年重复拍摄。患者每3个月复诊一次，持续2年，并重复上述操作。共检测到119个AL位点，其中89个为快速AL位点（RAL），30个为渐进性AL位点（GAL）。在附着丧失时间（ALT）和预测时间（PT），RAL位点的弹性蛋白酶水平（TA和EC）均显著高于同一患者的配对对照位点（p≤0.0001）。在研究期间，GAL位点的平均水平（TA和EC）显著高于同一患者的配对对照位点（p≤0.0001）。在2×2列联表中，使用125微单位/30秒（TA）和400微单位/微升（EC）的临界值（CV），在PT时显示敏感性为100%，特异性为99.95%（TA），敏感性为100%，特异性为99.91%（EC），在ALT时的值非常相似。患者水平比较显示，RAL和GAL位点的平均弹性蛋白酶水平（TA和EC）显著高于AL患者中的非附着丧失（NAL）位点，且AL患者的平均水平显著高于NAL患者。所有这些结果表明，这些龈沟液弹性蛋白酶活性的临界值可作为未来附着丧失的预测指标。
