CAJ | 학술논문

目的：观察和分析龋露髓牙患者牙髓血中前列腺素E2（PGE-2）及弹性蛋白酶（EA）水平的变化及其对直接盖髓术治疗效果的影响。方法选取80例行直接盖髓术治疗的龋露髓牙患者作为观察组，选取同期40例拔除正常阻生第三磨牙患者作为对照组。对两组患者治疗前的牙髓血中的 PGE-2和 EA水平进行检测和比较；对观察组患者进行为期一年的随访，对其治疗疗效进行评价和比较。结果观察组患者患牙牙髓血中 PGE-2和 EA水平分别为132.28±63.55 ng／ml和114.36±19.57μg／ml，对照组分别为0.61±1.26 ng／ml和19.38±6.34μg／ml，两组之间的差异均有统计学意义（t＝43.129，29.675，P＜0.05），观察组患者患牙牙髓血中PGE-2水平与 EA水平呈正相关关系（r＝0.782，P＜0.05）。治疗成功患者治疗前患牙牙髓血中的PGE-2水平和 EA水平分别为84.63±13.17 ng／ml和68.25±8.16μg／ml，治疗失败患者治疗前患牙牙髓血中的PGE-2水平和EA水平分别为177.35±41.42 ng／ml和152.36±16.28μg／ml，两者之间的差异均有统计学意义（t＝31.578，21.556，P＜0.05）。结论龋露髓牙患者表现为牙髓血中 PGE-2和 EA表达水平的明显升高，并且治疗前较高的PGE-2和 EA表达水平可对直接盖髓术的治疗疗效产生不利影响，临床医生应综合考虑患者的具体情况选取适当的治疗方法。
목적：관찰화분석우로수아환자아수혈중전렬선소E2（PGE-2）급탄성단백매（EA）수평적변화급기대직접개수술치료효과적영향。방법선취80례행직접개수술치료적우로수아환자작위관찰조，선취동기40례발제정상조생제삼마아환자작위대조조。대량조환자치료전적아수혈중적 PGE-2화 EA수평진행검측화비교；대관찰조환자진행위기일년적수방，대기치료료효진행평개화비교。결과관찰조환자환아아수혈중 PGE-2화 EA수평분별위132.28±63.55 ng／ml화114.36±19.57μg／ml，대조조분별위0.61±1.26 ng／ml화19.38±6.34μg／ml，량조지간적차이균유통계학의의（t＝43.129，29.675，P＜0.05），관찰조환자환아아수혈중PGE-2수평여 EA수평정정상관관계（r＝0.782，P＜0.05）。치료성공환자치료전환아아수혈중적PGE-2수평화 EA수평분별위84.63±13.17 ng／ml화68.25±8.16μg／ml，치료실패환자치료전환아아수혈중적PGE-2수평화EA수평분별위177.35±41.42 ng／ml화152.36±16.28μg／ml，량자지간적차이균유통계학의의（t＝31.578，21.556，P＜0.05）。결론우로수아환자표현위아수혈중 PGE-2화 EA표체수평적명현승고，병차치료전교고적PGE-2화 EA표체수평가대직접개수술적치료료효산생불리영향，림상의생응종합고필환자적구체정황선취괄당적치료방법。
Objective To observe and analyze the changes of prostaglandin E2 (PGE-2)and elastase (EA)levels in the pulp blood of the patients with carious tooth complicated with exposed pulp and its influence on the curative effects of direct pulp capping treatment.Methods 80 cases of the patients with carious tooth complicated with exposed pulp treated with direct pulp capping treatment were selected as the observation group and 40 cases of the patients treated with normal removal of impacted third molar were selected as the control group.The levels of PGE-2 and EA in the pulp blood of the patients in the two groups before the treatments were detected and compared.A one-year follow-up was employed for the patients in the observation group and the curative effects were evaluated and compared.Results The levels of PGE-2 and EA in the pulp blood of the patients in the observation group were 132.28±63.55 ng/ml and 114.36±19.57μg/ml respectively,and the levels of PGE-2 and EA in the pulp blood of the patients in the control group were 0.61±1.26 ng/ml and 19.38±6.34μg/ml respectively.There were statistically significant differences between the two groups (t=43.129,29.675,P<0.05). There was a positive relationship between the PGE-2 level and EA level in the pulp blood of the patients in the observation group (r=0.782,P<0.05).The levels of PGE-2 and EA in the pulp blood before the treatment of the patients with suc-cessful effects were 84.63±13.17 ng/ml and 68.25±8.16μg/ml,and the levels of PGE-2 and EA in the pulp blood before the treatment of the patients with failed effects were 177.35±41.42 ng/ml and 152.36±16.28μg/ml.There were statisti-cally significant differences between the two types of patients (t=31.578,21.556,P<0.05).Conclusion The patients with carious tooth complicated with exposed pulp show the significantly increased expression levels of PGE-2 and EA in pulp blood.The higher expression levels of PGE-2 and EA before the treatment could put adverse influence on the curative effects of direct pulp capping treatment.The clinicians should give the comprehensive consideration to the specific condition of pa-tients to choose the proper treatment methods.