CAJ | 학술논문

目的：探讨老年冠心病伴重度牙周炎患者不同牙周治疗后，牙周状况及血清肿瘤坏死因子（TNF-α）、白细胞介素-6（IL-6）和 C 反应蛋白（CRP）的变化。方法将90例伴有重度牙周炎的老年冠心病患者分为3组，每组30例，对照组仅进行冠心病治疗，基础组在冠心病治疗基础上进行牙周基础治疗，联合组患者在冠心病治疗基础上进行牙周基础治疗和翻瓣术，比较3组各观察指标的差异。结果联合组和基础组经牙周基础治疗后，牙周袋深度（PD）、龈沟出血指数（SBI）、斑指数（PLI）、探诊深度、探诊出血均明显下降（P ＜0．05），并有显著的附着获得（P ＜0．05）；联合组与基础组治疗后比较，PD、SBI、临床附着丧失（CAL）、探诊深度、探诊出血差异有统计学意义（P ＜0．05）。治疗后，联合组和基础组 TNF-α、IL-6及 CRP 水平较对照组明显降低（P ＜0．05）；基础组和联合组治疗后血清中 TNF-α、IL-6及 CRP 水平比较，差异有统计学意义（P ＜0．05）。结论牙周治疗和翻瓣术均能降低老年冠心病患者相关血清炎性因子 TNF-α、IL-6和 CRP 水平，但相对于牙周基础治疗，翻瓣术效果更佳。
목적：탐토노년관심병반중도아주염환자불동아주치료후，아주상황급혈청종류배사인자（TNF-α）、백세포개소-6（IL-6）화 C 반응단백（CRP）적변화。방법장90례반유중도아주염적노년관심병환자분위3조，매조30례，대조조부진행관심병치료，기출조재관심병치료기출상진행아주기출치료，연합조환자재관심병치료기출상진행아주기출치료화번판술，비교3조각관찰지표적차이。결과연합조화기출조경아주기출치료후，아주대심도（PD）、간구출혈지수（SBI）、반지수（PLI）、탐진심도、탐진출혈균명현하강（P ＜0．05），병유현저적부착획득（P ＜0．05）；연합조여기출조치료후비교，PD、SBI、림상부착상실（CAL）、탐진심도、탐진출혈차이유통계학의의（P ＜0．05）。치료후，연합조화기출조 TNF-α、IL-6급 CRP 수평교대조조명현강저（P ＜0．05）；기출조화연합조치료후혈청중 TNF-α、IL-6급 CRP 수평비교，차이유통계학의의（P ＜0．05）。결론아주치료화번판술균능강저노년관심병환자상관혈청염성인자 TNF-α、IL-6화 CRP 수평，단상대우아주기출치료，번판술효과경가。
Objective To observe the effect of different periodontal therapies on serum levels of tumor necrosis factor-alpha (TNF-α),interleukin-6(IL-6)and C-reactive protein (CRP)in elderly patients with coronary.Methods Totally 90 elderly patients with severe periodontitis were divided into three groups,the control group performed the treatment of coronary heart disease;the periodontal treatment group performed the treatment of coronary heart disease and periodontal treatment;the combine group per-formed periodontal therapy and flap surgery on the basis of the treatment of coronary heart disease.The obvervational index were compared among three groups.Results All patients′clinical indexes of periodontitis of combination group and basic group has im-proved after treatment,the levels of PD,SBI,CAL,PLI,the percentage of bleeding on probing and probing depth were significantly decreased (P <0.05),and had significant adhesion(P <0.05);the contrast between combination group and basic group,the levels of PD,SBI,CAL,the percentage of bleeding on probing and probing depth had notable difference(P <0.05).All patients′clinical indexes of periodontitis of combination group and basic group had improved after treatment,serum levels of TNF-α,IL-6 and CRP were significantly decreased (P <0.05);the contrast between combination group and basic group,serum levels of TNF-α,IL-6 and CRP have notable difference (P <0.05).Conclusion The periodontal basic therapy and periodontal flap therapy can reduce the ser-um levels of TNF-α,IL-6 and CRP of elderly coronary heart disease (CHD),but compared to the routine medicine maintenance therapy,the effect of periodontal flap therapy is better.