CAJ | 학술논문

目的：探讨心理应激对大鼠实验性牙周炎的影响，观察高压氧（ hyperbaric oxygen， HBO）治疗对心理应激相关牙周炎的疗效。方法：清洁级4周龄雄性Wistar大鼠80只，随机分为4组：（1）正常对照组；（2）牙周炎组：用浸有牙龈卟啉单胞菌株的丝线结扎左侧上颌第2磨牙牙颈部，复制实验性牙周炎模型；（3）单纯应激组；（4）牙周炎＋应激组。于实验后第9周停止应激刺激，对除正常对照组外其它各组大鼠每组选取4只进行HBO治疗。于实验后2、4和8周末分批处死动物，每组处死4只，于实验后10周末处死动物，每组处死8只。采血检测血糖浓度、血浆促肾上腺皮质激素（ ACTH）、皮质类固醇和肾上腺素含量。测量术区的牙周附着情况，制作牙体牙周联合切片，观察牙周的组织学改变。结果：检测应激标记物的变化可见单纯应激组的血糖及血浆ACTH、皮质类固醇和肾上腺素含量在实验后第2、4周明显高于正常对照组和牙周炎组（ P＜0．01），第8周时血糖降至正常水平，但血浆ACTH、皮质类固醇和肾上腺素含量仍高于正常对照组和牙周炎组（ P＜0．05）；牙周炎＋应激组在实验后第2、4和8周血糖及血浆ACTH、皮质类固醇和肾上腺素含量均高于正常对照组和牙周炎组（ P＜0．05）；HBO治疗组牙周炎＋应激组血糖明显低于非治疗组（ P＜0．01），单纯应激组和牙周炎＋应激组血浆ACTH、皮质类固醇和肾上腺素水平显著下降（P＜0．01）。大体观察可见正常对照组及单纯应激组牙周附着位置正常；牙周炎组出现牙龈萎缩，附着丧失明显；牙周炎＋应激组附着丧失明显，根分叉暴露，HBO治疗后，牙龈水肿减轻，牙周袋变浅。单纯应激组与正常对照组在各时点的牙周附着水平的差异不显著（P＞0．05）；牙周炎＋应激组附着丧失程度在各时点均明显高于牙周炎组（P＜0．01）；HBO治疗结束后牙周炎组及牙周炎＋应激组牙周附着丧失程度减轻（P＜0．01）。组织学观察可见牙周炎＋应激组牙周组织破坏程度在各时点均重于牙周炎组；经HBO治疗后，牙周组织炎症程度减轻，炎症细胞浸润减少。结论：心理应激可加重牙周炎进程。 HBO对大鼠实验性牙周炎及心理应激相关牙周炎均有治疗效果。目的：探討心理應激對大鼠實驗性牙週炎的影響，觀察高壓氧（ hyperbaric oxygen， HBO）治療對心理應激相關牙週炎的療效。方法：清潔級4週齡雄性Wistar大鼠80隻，隨機分為4組：（1）正常對照組；（2）牙週炎組：用浸有牙齦卟啉單胞菌株的絲線結扎左側上頜第2磨牙牙頸部，複製實驗性牙週炎模型；（3）單純應激組；（4）牙週炎＋應激組。于實驗後第9週停止應激刺激，對除正常對照組外其它各組大鼠每組選取4隻進行HBO治療。于實驗後2、4和8週末分批處死動物，每組處死4隻，于實驗後10週末處死動物，每組處死8隻。採血檢測血糖濃度、血漿促腎上腺皮質激素（ ACTH）、皮質類固醇和腎上腺素含量。測量術區的牙週附著情況，製作牙體牙週聯閤切片，觀察牙週的組織學改變。結果：檢測應激標記物的變化可見單純應激組的血糖及血漿ACTH、皮質類固醇和腎上腺素含量在實驗後第2、4週明顯高于正常對照組和牙週炎組（ P＜0．01），第8週時血糖降至正常水平，但血漿ACTH、皮質類固醇和腎上腺素含量仍高于正常對照組和牙週炎組（ P＜0．05）；牙週炎＋應激組在實驗後第2、4和8週血糖及血漿ACTH、皮質類固醇和腎上腺素含量均高于正常對照組和牙週炎組（ P＜0．05）；HBO治療組牙週炎＋應激組血糖明顯低于非治療組（ P＜0．01），單純應激組和牙週炎＋應激組血漿ACTH、皮質類固醇和腎上腺素水平顯著下降（P＜0．01）。大體觀察可見正常對照組及單純應激組牙週附著位置正常；牙週炎組齣現牙齦萎縮，附著喪失明顯；牙週炎＋應激組附著喪失明顯，根分扠暴露，HBO治療後，牙齦水腫減輕，牙週袋變淺。單純應激組與正常對照組在各時點的牙週附著水平的差異不顯著（P＞0．05）；牙週炎＋應激組附著喪失程度在各時點均明顯高于牙週炎組（P＜0．01）；HBO治療結束後牙週炎組及牙週炎＋應激組牙週附著喪失程度減輕（P＜0．01）。組織學觀察可見牙週炎＋應激組牙週組織破壞程度在各時點均重于牙週炎組；經HBO治療後，牙週組織炎癥程度減輕，炎癥細胞浸潤減少。結論：心理應激可加重牙週炎進程。 HBO對大鼠實驗性牙週炎及心理應激相關牙週炎均有治療效果。
목적：탐토심리응격대대서실험성아주염적영향，관찰고압양（ hyperbaric oxygen， HBO）치료대심리응격상관아주염적료효。방법：청길급4주령웅성Wistar대서80지，수궤분위4조：（1）정상대조조；（2）아주염조：용침유아간계람단포균주적사선결찰좌측상합제2마아아경부，복제실험성아주염모형；（3）단순응격조；（4）아주염＋응격조。우실험후제9주정지응격자격，대제정상대조조외기타각조대서매조선취4지진행HBO치료。우실험후2、4화8주말분비처사동물，매조처사4지，우실험후10주말처사동물，매조처사8지。채혈검측혈당농도、혈장촉신상선피질격소（ ACTH）、피질류고순화신상선소함량。측량술구적아주부착정황，제작아체아주연합절편，관찰아주적조직학개변。결과：검측응격표기물적변화가견단순응격조적혈당급혈장ACTH、피질류고순화신상선소함량재실험후제2、4주명현고우정상대조조화아주염조（ P＜0．01），제8주시혈당강지정상수평，단혈장ACTH、피질류고순화신상선소함량잉고우정상대조조화아주염조（ P＜0．05）；아주염＋응격조재실험후제2、4화8주혈당급혈장ACTH、피질류고순화신상선소함량균고우정상대조조화아주염조（ P＜0．05）；HBO치료조아주염＋응격조혈당명현저우비치료조（ P＜0．01），단순응격조화아주염＋응격조혈장ACTH、피질류고순화신상선소수평현저하강（P＜0．01）。대체관찰가견정상대조조급단순응격조아주부착위치정상；아주염조출현아간위축，부착상실명현；아주염＋응격조부착상실명현，근분차폭로，HBO치료후，아간수종감경，아주대변천。단순응격조여정상대조조재각시점적아주부착수평적차이불현저（P＞0．05）；아주염＋응격조부착상실정도재각시점균명현고우아주염조（P＜0．01）；HBO치료결속후아주염조급아주염＋응격조아주부착상실정도감경（P＜0．01）。조직학관찰가견아주염＋응격조아주조직파배정도재각시점균중우아주염조；경HBO치료후，아주조직염증정도감경，염증세포침윤감소。결론：심리응격가가중아주염진정。 HBO대대서실험성아주염급심리응격상관아주염균유치료효과。
[ ABSTRACT] AIM:To investigate the role of chronic psychological stress on periodontitis and the effects of hy-perbaric oxygen ( HBO) on periodontitis with psychological stress in rats.METHODS:Male special pathogen-free Wistar rats (n=80) were randomly divided into 4 groups:(1)normal control group;(2)experimental periodontitis group:the pe-riodontitis model was induced by wrapping 3/0 silk ligature inoculated with Porphyromonas gingivalis around the left maxil-lary second molar of the rats; ( 3 ) psychological stress stimulation group; ( 4 ) periodontitis model with stress stimulation group.Psychological stress was removed at the 9th week after ligature, and 4 rats from each experimental group were ran-domly chosen for HBO treatment.The rats were sacrificed at the 2nd, 4th, 8th and 10th weeks after ligature.The levels of blood glucose, adrenocorticotropic hormone ( ACTH) , corticosterone and adrenaline were measured as the stress markers. The histological changes of periodontal tissues were observed under microscope with HE staining.RESULTS:The levels of blood glucose, ACTH, corticosterone and adrenaline in psychological stress stimulation group and periodontitis with stress group were significantly higher than those in control group and experimental periodontitis group at the 2nd and 4th weeks af-ter ligature (P<0.05).The levels of the stress markers were significantly lower than those in untreated groups in the 10th week after HBO (P<0.01).The sites of gingival attachment were normal in control group and psychological stress stimu-lation group.Periodontal pocket, and periodontal attachment loss ( AL) were observed in experimental periodontitis group. The tissue damage was much heavier in periodontitis model with stress stimulation group as the furcation of tooth was ex-posed and the tissue damage was observed on both sides of the adjacent teeth.No significant difference of AL between psy-chological stress stimulation group and normal control group during the experiment was observed.The AL in periodontal model with stress stimulating group was significantly higher than that in experimental periodontitis group at the 2nd, 4th and 8th weeks (P<0.01).The level of AL was attenuated at the 10th week after HBO (P<0.01).No difference of histologi-cal change in periodontal tissues was observed between control group and psychological stress stimulation group.Severer in-flammatory changes and alveolar bone destruction were observed in periodontitis with stress group than those in experimental periodontitis group.The levels of inflammation reduced at the 10th week after HBO.CONCLUSION:Stress stimulation is one of the inducing factors of periodontitis in rats, which aggravates periodontitis.HBO may represent a useful way in trea-ting psychological stress periodontitis.