Eley B M, Cox S W
Periodontal Department, King's College School of Medicine and Dentistry, London, UK.
J Periodontal Res. 1996 Aug;31(6):381-92. doi: 10.1111/j.1600-0765.1996.tb00507.x.
This study aims to determine whether gingival crevicular fluid (GCF) cathepsin B levels, total activity (TA) and concentration (EC) predict progressive attachment loss (AL). Seventy-five previously untreated patients with moderate periodontitis were recruited. GCF was collected from 16 molar and premolar mesiobuccal sites and probing attachment level (PAL) and probing depth (PPD) were measured with an electronic probe. Gingival, gingival bleeding and plaque indices were then scored. Prior to baseline patients were given basic periodontal treatment after which the above procedures were repeated. Carefully localized radiographs were taken of the test teeth and repeated annually. Patients were seen 3-monthly for 2 yr and the procedures were repeated. One hundred and twenty-one AL sites, 90 rapid AL (RAL) and 31 gradual AL (GAL), in 49 patients were detected. Cathepsin B levels (TA & EC) at RAL sites were significantly higher (p < 0.0001) than paired control sites at the attachment loss time (ALT) and prediction time (PT). Mean levels (TA & EC) over the study period at GAL sites were significantly higher (p < 0.0001) than paired control sites. Using a critical value (CV) of 7.5 microU/30 s (TA) and 30 microU/microL (EC) showed a sensitivity of 100% and specificity of 99.83% (TA) and 100% and 99.75%(EC) at both ALT & PT. Mean cathepsin B levels (TA & EC) were significantly higher (p < 0.0001) at RAL and GAL sites than non-attachment loss (NAL) sites in AL patients in intrapatient comparisons and mean patient levels were significantly higher (p < 0.0001) in AL patients than NAL patients in interpatient comparisons. These results indicate that GCF cathepsin B may serve as a predictor of attachment loss.
本研究旨在确定龈沟液（GCF）组织蛋白酶B水平、总活性（TA）和浓度（EC）是否可预测附着丧失（AL）的进展。招募了75例既往未经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，并用电子探针测量探诊附着水平（PAL）和探诊深度（PPD）。然后对牙龈、牙龈出血和菌斑指数进行评分。在基线前，患者接受基础牙周治疗，之后重复上述操作。对受试牙齿进行仔细定位的X线片拍摄，并每年重复一次。患者每3个月复诊一次，持续2年，并重复相关操作。在49例患者中检测到121个AL位点，其中90个快速AL（RAL）位点和31个缓慢AL（GAL）位点。RAL位点在附着丧失时间（ALT）和预测时间（PT）的组织蛋白酶B水平（TA和EC）显著高于配对的对照位点（p < 0.0001）。GAL位点在研究期间的平均水平（TA和EC）显著高于配对的对照位点（p < 0.0001）。使用7.5微单位/30秒（TA）和30微单位/微升（EC）的临界值（CV），在ALT和PT时，TA的敏感性为100%，特异性为99.83%；EC的敏感性为100%，特异性为99.75%。在患者内比较中，RAL和GAL位点的组织蛋白酶B平均水平（TA和EC）显著高于AL患者中的非附着丧失（NAL）位点；在患者间比较中，AL患者的平均水平显著高于NAL患者（p < 0.0001）。这些结果表明，龈沟液组织蛋白酶B可能作为附着丧失的一个预测指标。
