目的 模拟慢性牙周炎(chronic periodontitis,CP)患者临床治疗中的干预措施,研究不同口腔干预方式对CP大鼠动脉粥样硬化(atherosclerosis,As)发生及发展的影响,以期为牙周炎患者最佳治疗方案的制定提供参考.方法 用数字随机数字表法将50只SD大鼠随机分为A组(正常对照组,7只)、B组(As组,8只)、C组(CP组,35只).建模成功后,再将C组分为C1组(自然进程)、C2组(牙周机械治疗)、C3组(药物治疗)、C4-1组(拔牙)和C4-2组(拔牙+抗生素),每组均为7只.按上述措施分别进行口腔干预,酶联免疫吸附法检测建模成功后1、3、5、7和9周血清白细胞介素6(interleukin-6,IL-6)的含量;免疫组化法检测颈动脉组织中基质金属蛋白酶2,9(matrixmetalloproteinase-2,9,MMP-2,9)的表达.结果 血清学结果显示:随着时间推移,B和C1组血清IL-6含量呈升高趋势,且显著高于A组(P＜0.01);各干预组(C2、C3、C4-1、C4-2组)IL-6含量逐渐升高,并在建模成功后5周达峰值[C2、C3、C4-1、C4-2组分别为(62.3±14.3)、(58.2±8.7)、(127.0±29.9)及(120.6±23.1) ng/L],且均显著高于B组[(43.4±7.5) ng/L,P＜0.01],其中C4-1和C4-2组升高最明显,均接近B组的3倍,C2和C3组接近B组的1.5倍,之后逐渐下降.建模成功后9周,C2组[(28.6±8.1) ng/L、C3组[(40.8±15.1) ng/L]、C4-2组[(32.7± 11.1) ng/L]均显著低于B组[(66.3±7.8) ng/L](P＜0.05),且C2组最低;C4-1组(72.8±16.4)虽下降明显,但仍为最高.免疫组化结果显示:B、C1和C4-1组MMP-2,9大量阳性表达,且阳性染色强度均明显高于A组(MMP-2,9灰度值分别为:183.0±2.0、181.3±2.0),灰度值差异有统计学意义(P＜0.01),其中C4-1组阳性染色最强,B和C1组依次降低(MMP-2,9的灰度值分别为C4-1:123.1±2.9、121.0±3.2;B:126.4±2.0、124.8±2.8;C1:140.0±2.2、139.7±3.2)(P＜0.01);C2、C3和C4-2组阳性染色强度均明显低于C1组(C2:169.3±3.4、169.7±2.3;C3:149.0±1.7、145.1±2.5;C4-2:157.7±1.2、155.8±2.7)(P＜0.01),C2组阳性染色最弱.结论 单纯慢性牙周炎SD大鼠的牙周炎症若不加干预,其发生As的风险将逐渐增高;牙周机械治疗在短期内可能增加As发生、发展的风险,但随时间延长风险逐渐降低,对血管的改善程度效果最明显;直接拔牙风险较高,拔牙后全身应用甲硝唑可明显降低风险.
目的 模擬慢性牙週炎(chronic periodontitis,CP)患者臨床治療中的榦預措施,研究不同口腔榦預方式對CP大鼠動脈粥樣硬化(atherosclerosis,As)髮生及髮展的影響,以期為牙週炎患者最佳治療方案的製定提供參攷.方法 用數字隨機數字錶法將50隻SD大鼠隨機分為A組(正常對照組,7隻)、B組(As組,8隻)、C組(CP組,35隻).建模成功後,再將C組分為C1組(自然進程)、C2組(牙週機械治療)、C3組(藥物治療)、C4-1組(拔牙)和C4-2組(拔牙+抗生素),每組均為7隻.按上述措施分彆進行口腔榦預,酶聯免疫吸附法檢測建模成功後1、3、5、7和9週血清白細胞介素6(interleukin-6,IL-6)的含量;免疫組化法檢測頸動脈組織中基質金屬蛋白酶2,9(matrixmetalloproteinase-2,9,MMP-2,9)的錶達.結果 血清學結果顯示:隨著時間推移,B和C1組血清IL-6含量呈升高趨勢,且顯著高于A組(P＜0.01);各榦預組(C2、C3、C4-1、C4-2組)IL-6含量逐漸升高,併在建模成功後5週達峰值[C2、C3、C4-1、C4-2組分彆為(62.3±14.3)、(58.2±8.7)、(127.0±29.9)及(120.6±23.1) ng/L],且均顯著高于B組[(43.4±7.5) ng/L,P＜0.01],其中C4-1和C4-2組升高最明顯,均接近B組的3倍,C2和C3組接近B組的1.5倍,之後逐漸下降.建模成功後9週,C2組[(28.6±8.1) ng/L、C3組[(40.8±15.1) ng/L]、C4-2組[(32.7± 11.1) ng/L]均顯著低于B組[(66.3±7.8) ng/L](P＜0.05),且C2組最低;C4-1組(72.8±16.4)雖下降明顯,但仍為最高.免疫組化結果顯示:B、C1和C4-1組MMP-2,9大量暘性錶達,且暘性染色彊度均明顯高于A組(MMP-2,9灰度值分彆為:183.0±2.0、181.3±2.0),灰度值差異有統計學意義(P＜0.01),其中C4-1組暘性染色最彊,B和C1組依次降低(MMP-2,9的灰度值分彆為C4-1:123.1±2.9、121.0±3.2;B:126.4±2.0、124.8±2.8;C1:140.0±2.2、139.7±3.2)(P＜0.01);C2、C3和C4-2組暘性染色彊度均明顯低于C1組(C2:169.3±3.4、169.7±2.3;C3:149.0±1.7、145.1±2.5;C4-2:157.7±1.2、155.8±2.7)(P＜0.01),C2組暘性染色最弱.結論 單純慢性牙週炎SD大鼠的牙週炎癥若不加榦預,其髮生As的風險將逐漸增高;牙週機械治療在短期內可能增加As髮生、髮展的風險,但隨時間延長風險逐漸降低,對血管的改善程度效果最明顯;直接拔牙風險較高,拔牙後全身應用甲硝唑可明顯降低風險.
목적 모의만성아주염(chronic periodontitis,CP)환자림상치료중적간예조시,연구불동구강간예방식대CP대서동맥죽양경화(atherosclerosis,As)발생급발전적영향,이기위아주염환자최가치료방안적제정제공삼고.방법 용수자수궤수자표법장50지SD대서수궤분위A조(정상대조조,7지)、B조(As조,8지)、C조(CP조,35지).건모성공후,재장C조분위C1조(자연진정)、C2조(아주궤계치료)、C3조(약물치료)、C4-1조(발아)화C4-2조(발아+항생소),매조균위7지.안상술조시분별진행구강간예,매련면역흡부법검측건모성공후1、3、5、7화9주혈청백세포개소6(interleukin-6,IL-6)적함량;면역조화법검측경동맥조직중기질금속단백매2,9(matrixmetalloproteinase-2,9,MMP-2,9)적표체.결과 혈청학결과현시:수착시간추이,B화C1조혈청IL-6함량정승고추세,차현저고우A조(P＜0.01);각간예조(C2、C3、C4-1、C4-2조)IL-6함량축점승고,병재건모성공후5주체봉치[C2、C3、C4-1、C4-2조분별위(62.3±14.3)、(58.2±8.7)、(127.0±29.9)급(120.6±23.1) ng/L],차균현저고우B조[(43.4±7.5) ng/L,P＜0.01],기중C4-1화C4-2조승고최명현,균접근B조적3배,C2화C3조접근B조적1.5배,지후축점하강.건모성공후9주,C2조[(28.6±8.1) ng/L、C3조[(40.8±15.1) ng/L]、C4-2조[(32.7± 11.1) ng/L]균현저저우B조[(66.3±7.8) ng/L](P＜0.05),차C2조최저;C4-1조(72.8±16.4)수하강명현,단잉위최고.면역조화결과현시:B、C1화C4-1조MMP-2,9대량양성표체,차양성염색강도균명현고우A조(MMP-2,9회도치분별위:183.0±2.0、181.3±2.0),회도치차이유통계학의의(P＜0.01),기중C4-1조양성염색최강,B화C1조의차강저(MMP-2,9적회도치분별위C4-1:123.1±2.9、121.0±3.2;B:126.4±2.0、124.8±2.8;C1:140.0±2.2、139.7±3.2)(P＜0.01);C2、C3화C4-2조양성염색강도균명현저우C1조(C2:169.3±3.4、169.7±2.3;C3:149.0±1.7、145.1±2.5;C4-2:157.7±1.2、155.8±2.7)(P＜0.01),C2조양성염색최약.결론 단순만성아주염SD대서적아주염증약불가간예,기발생As적풍험장축점증고;아주궤계치료재단기내가능증가As발생、발전적풍험,단수시간연장풍험축점강저,대혈관적개선정도효과최명현;직접발아풍험교고,발아후전신응용갑초서가명현강저풍험.
Objective To establish chronic periodontitis model in SD rats,and to investigate the effect of oral intervention on atherosclerosis.Methods Fifty male SD rats were randomly divided into three groups,group A(normal control),group B(atherosclerosis,As) and group C(chronic periodontitis,CP).Group C was further divided into group C1(natural process),group C2(simple mechanical treatment),group C3 (systemic antibiotics),group C4-1(teeth extraction) and group C4-2(teeth extraction+systemic antibiotics),each group consisted of 7 rats.Every group received oral intervention.Serum interleukin(IL)-6 levels were detected in five different time points(1,3,5,7,9 weeks after a successful modeling) by enzyme linked immunosorbent assay.All animals were killed after 24 weeks.Matrix metalloproteinase(MMP)-2,9 in the proximal aorta was detected by immuno histochemistry.Results The levels of serum IL-6 in groups B and C1 increased gradually with time and became significantly higher than that in group A(P＜0.01).Levels of serum IL-6 were increased gradually in each intervention group(C2,C3,C4-1,C4-2) and reached its peak at 5 weeks after modeling[C2:(62.3 ± 14.3) ng/L,C3:(58.2±8.7) ng/L,C4-1:(127.0±29.9) ng/L,C4-2:(120.6± 23.1) ng/L].Compared with group B,group C4-1 and C4-2 increased most significantly(P＜0.01).Levels of serum IL-6 decreased gradually.Eventually,group C2[(28.6± 8.1) ng/L],C3[(40.8 ± 15.1) ng/L] and C4-2 [(32.7± 11.1) ng/L] were significantly lower than group B(P＜0.05),and in group C2 IL-6 was the lowest.Although levels of serum of IL-6 significantly decreased in group C4-1[(72.8± 16.4) ng/L],but remained the highest.Immunohistochemistry showed that MMP-2,9 were expressed in group B,C 1 and C4-1,and significantly higher than in group A(183.0±2.0,181.3 ± 2.0),the gray value differences were statistically significant(P＜0.01).Group C4-1 (123.1 ±2.9,121.0± 3.2) was the strongest,group B (126.4±2.0,124.8 ±2.8)and C1 (140.0±2.2,139.7±3.2) were decreased (P＜0.01).While group C2(169.3±3.4,169.7±2.3),C3 (149.0±1.7,145.1±2.5) and C4-2(157.7± 1.2,155.8±2.7) were significantly lower than group C1(P＜0.01),and group C2 was close to normal.Conclusions Periodontitis could increase the risk of atherosclerosis in rats with chronic periodontitis.Periodontal mechanical treatment and teeth extraction may increase the risk of As in the short time.However,the risk would gradually reduce in a long time.
