目的 通过研究牙周基础治疗对伴动脉粥样硬化(atherosclerosis,As)慢性牙周炎(chronic periodontitis,CP)大鼠的影响,以期为临床提供参考.方法 44只清洁级SD大鼠按随机数字表法随机分为A组(正常对照组,7只)、B组(As组,建立As模型,8只)及C组(CP+ As组,建立CP+ As模型,29只).建模后将C组再应用随机数字表法分为4个小组,CI组:自然进程组,C2组:单纯机械治疗组,C3组:机械治疗+盐酸米诺环素(派丽奥)组,C4组:机械治疗+盐酸米诺环素+抗生素组,每组7只.建模后15周按随机数字表法处死B、C组大鼠各1只,分别进行血管病理切片发现有脂质沉积形成,同时观察C组大鼠口腔出现牙周炎表现,证明As及CP+ As建模成功,开始口腔干预.分别于建模后第1、3、5、7和9周应用酶联免疫吸附测定法检测血清中白细胞介素6(interleukin-6,IL-6)的浓度,免疫组化法定性检测各组大鼠颈动脉血管壁组织的基质金属蛋白酶(matrix metalloproteinase,MMP)2、MMP-9并测量其灰度值.结果 各组MMP-2,9的灰度值趋势基本一致,B、C组颈动脉的内膜、中膜阳性染色深度均明显大于A组.C1组(MMP-2,9的灰度值分别为101.3±2.4、101.2±4.1)有As斑块形成,染色深度明显强于B组(MMP-2,9的灰度值分别为12.6.4±2.0、124.8±2.8)(P＜0.05);C2、C3和C4组染色范围及程度依次减弱,且均弱于C1组,与C1组的灰度值相比差异均有统计学意义(P＜0.05).血清检测结果显示,随着时间推移,B、C1组血清IL-6浓度一直呈升高趋势,均显著高于A组(P＜0.01);C2、C3、C4组血清IL-6浓度均为先升后降,在建模后第5周达峰值,其中C2组最高,从第4次取样时间点起,各组IL-6含量均显著低于C1组(P＜0.001),C3、C4组显著低于C2组(P＜0.01).结论 对于伴有As的CP大鼠,若不及时控制CP,可能会加重As的病变程度;牙周机械治疗可能会短期内增高机体炎症反应程度,而长期则可能降低血管炎症,减缓其As病变程度;牙周机械治疗时辅以局部及全身抗炎药物后,颈动脉血管病变及全身炎症可以得到更好的改善.
目的 通過研究牙週基礎治療對伴動脈粥樣硬化(atherosclerosis,As)慢性牙週炎(chronic periodontitis,CP)大鼠的影響,以期為臨床提供參攷.方法 44隻清潔級SD大鼠按隨機數字錶法隨機分為A組(正常對照組,7隻)、B組(As組,建立As模型,8隻)及C組(CP+ As組,建立CP+ As模型,29隻).建模後將C組再應用隨機數字錶法分為4箇小組,CI組:自然進程組,C2組:單純機械治療組,C3組:機械治療+鹽痠米諾環素(派麗奧)組,C4組:機械治療+鹽痠米諾環素+抗生素組,每組7隻.建模後15週按隨機數字錶法處死B、C組大鼠各1隻,分彆進行血管病理切片髮現有脂質沉積形成,同時觀察C組大鼠口腔齣現牙週炎錶現,證明As及CP+ As建模成功,開始口腔榦預.分彆于建模後第1、3、5、7和9週應用酶聯免疫吸附測定法檢測血清中白細胞介素6(interleukin-6,IL-6)的濃度,免疫組化法定性檢測各組大鼠頸動脈血管壁組織的基質金屬蛋白酶(matrix metalloproteinase,MMP)2、MMP-9併測量其灰度值.結果 各組MMP-2,9的灰度值趨勢基本一緻,B、C組頸動脈的內膜、中膜暘性染色深度均明顯大于A組.C1組(MMP-2,9的灰度值分彆為101.3±2.4、101.2±4.1)有As斑塊形成,染色深度明顯彊于B組(MMP-2,9的灰度值分彆為12.6.4±2.0、124.8±2.8)(P＜0.05);C2、C3和C4組染色範圍及程度依次減弱,且均弱于C1組,與C1組的灰度值相比差異均有統計學意義(P＜0.05).血清檢測結果顯示,隨著時間推移,B、C1組血清IL-6濃度一直呈升高趨勢,均顯著高于A組(P＜0.01);C2、C3、C4組血清IL-6濃度均為先升後降,在建模後第5週達峰值,其中C2組最高,從第4次取樣時間點起,各組IL-6含量均顯著低于C1組(P＜0.001),C3、C4組顯著低于C2組(P＜0.01).結論 對于伴有As的CP大鼠,若不及時控製CP,可能會加重As的病變程度;牙週機械治療可能會短期內增高機體炎癥反應程度,而長期則可能降低血管炎癥,減緩其As病變程度;牙週機械治療時輔以跼部及全身抗炎藥物後,頸動脈血管病變及全身炎癥可以得到更好的改善.
목적 통과연구아주기출치료대반동맥죽양경화(atherosclerosis,As)만성아주염(chronic periodontitis,CP)대서적영향,이기위림상제공삼고.방법 44지청길급SD대서안수궤수자표법수궤분위A조(정상대조조,7지)、B조(As조,건립As모형,8지)급C조(CP+ As조,건립CP+ As모형,29지).건모후장C조재응용수궤수자표법분위4개소조,CI조:자연진정조,C2조:단순궤계치료조,C3조:궤계치료+염산미낙배소(파려오)조,C4조:궤계치료+염산미낙배소+항생소조,매조7지.건모후15주안수궤수자표법처사B、C조대서각1지,분별진행혈관병리절편발현유지질침적형성,동시관찰C조대서구강출현아주염표현,증명As급CP+ As건모성공,개시구강간예.분별우건모후제1、3、5、7화9주응용매련면역흡부측정법검측혈청중백세포개소6(interleukin-6,IL-6)적농도,면역조화법정성검측각조대서경동맥혈관벽조직적기질금속단백매(matrix metalloproteinase,MMP)2、MMP-9병측량기회도치.결과 각조MMP-2,9적회도치추세기본일치,B、C조경동맥적내막、중막양성염색심도균명현대우A조.C1조(MMP-2,9적회도치분별위101.3±2.4、101.2±4.1)유As반괴형성,염색심도명현강우B조(MMP-2,9적회도치분별위12.6.4±2.0、124.8±2.8)(P＜0.05);C2、C3화C4조염색범위급정도의차감약,차균약우C1조,여C1조적회도치상비차이균유통계학의의(P＜0.05).혈청검측결과현시,수착시간추이,B、C1조혈청IL-6농도일직정승고추세,균현저고우A조(P＜0.01);C2、C3、C4조혈청IL-6농도균위선승후강,재건모후제5주체봉치,기중C2조최고,종제4차취양시간점기,각조IL-6함량균현저저우C1조(P＜0.001),C3、C4조현저저우C2조(P＜0.01).결론 대우반유As적CP대서,약불급시공제CP,가능회가중As적병변정도;아주궤계치료가능회단기내증고궤체염증반응정도,이장기칙가능강저혈관염증,감완기As병변정도;아주궤계치료시보이국부급전신항염약물후,경동맥혈관병변급전신염증가이득도경호적개선.
Objective To investigate the effect of periodontal mechanical treatment on serum interleukin-6 (IL-6) and carotid artery matrix metalloproteinase(MMP)-2 and MMP-9 expression in chronic periodontitis(CP) SD rats with atherosclerosis (As).Methods Forty-four six-week-old male SD rats were randomly divided into three groups:control group(group A),As group (group B),As + CP group (group C).According to different periodontal interventions,group C was randomly subdivided into four groups:natural process group (C 1),the periodontal mechanical treatment group (C2),the periodontal mechanical treatment + local drugs group(C3),and the periodontal mechanical treatment + local and system drugs group(C4).Each group received the appropriate treatment and periodontal interventions.Serum IL-6 levels were determined by enzyme linked immunosorrbent assay (ELISA).MMP-2 and MMP-9 levels in the proximal aorta were examined by immunohistochemistry.Results The gray value of MMP-2 and MMP-9 was basically the same in all groups.Compared with group A,the gray value of MMP-2 and MMP-9 of group B and C were decreased.C1 group showed the formation of atherosclerotic plaque and fibrous cap.Compared with group B (126.4 ± 2.0,124.8 ± 2.8),the gray value of group C1 (101.3 ± 2.4,101.2 ± 4.1) was significantly weaker(P ＜ 0.05).The staining depth of MMP-2 and MMP-9 of groups C1,C2,C3 and C4 were sequentially decreased,and the differences of gray value were statistically significant(P ＜ 0.05).The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that of group A(P ＜ 0.01).The levels of serum IL-6 in groups C2,C3,and C4 increased gradually and reached the peak 5 weeks after the establishment of model (P ＜ 0.001).After that,the levels of serum IL-6 decreased gradually and was lower than baseline.The levels of serum IL-6 in groups C3 and C4 were significantly lower than that in group C2 7 weeks after the establishment of model(P ＜ 0.01).Conclusions In rats with periodontitis and cardiovascular diseases,chronic periodontal inflammation may significantly increase the severity of As and promote the formation of atherosclerotic plaque.Mechanical periodontal therapy may cause short-term systemic inflammation and then reduce vascular inflammation in long term.With supplement use of local and systemic antibiotics,the mechanical periodontal therapy may get the vascular disease and systemic inflammation improved.
