上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (11): 1489-1494.doi: 10.3969/j.issn.1674-8115.2020.11.009

• 论著·临床研究 • 上一篇    下一篇

牙周基础治疗对腹膜透析牙周炎患者临床效果的观察

卢维立1，张旭云1，廖 悦1，陈慧文1，刘英莉2，宋忠臣1   

  1. 1. 上海交通大学医学院附属第九人民医院口腔医学院牙周病科，国家口腔疾病临床医学研究中心，上海市口腔医学重点实验室，上海市口腔医学研究所，上海 200011；2. 上海交通大学医学院附属第九人民医院肾脏内科，上海 200011
  • 出版日期:2020-11-28 发布日期:2021-01-13
  • 通讯作者: 宋忠臣，电子信箱：szhongchen@sina.com。
  • 作者简介:卢维立（1992—），男，主治医师，硕士；电子信箱：luweili2017@163.com。
  • 基金资助:
    国家重点研发计划（2017YFC0840100，2017YFC0840110）；上海交通大学医学院附属第九人民医院临床研究助推计划（JYLJ201811）；上海交通大学医学院附属第九人民医院生物样本库项目（YBKB201905）。

Clinical effect of periodontal initial therapy on peritoneal dialysis patients with periodontitis

LU Wei-li1, ZHANG Xu-yun1, LIAO Yue1, CHEN Hui-wen1, LIU Ying-li2, SONG Zhong-chen1   

  1. 1. Department of Periodontology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China; 2. Division of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2020-11-28 Published:2021-01-13
  • Supported by:
    National Key R&D Program of China (2017YFC0840100, 2017YFC0840110); Clinical Research Program of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (JYLJ201811); Project of Biobank from Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (YBKB201905).

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摘要： 目的·观察牙周基础治疗对伴慢性牙周炎的尿毒症腹膜透析患者的临床治疗效果。方法·收集在上海交通大学医学院附属第九人民医院、复旦大学附属华山医院肾内科行腹膜透析治疗并伴慢性牙周炎的尿毒症患者33例，随机分为试验组（16例）和对照组（17例），前者行牙周基础治疗和腹膜透析治疗，后者仅行腹膜透析治疗。观察2组患者治疗前后的牙周临床指标包括菌斑指数（plaque index，PLI）、出血指数（bleeding index，BI）、探诊深度（probing depth，PD）及临床附着丧失（clinical attachment loss，CAL），以及实验室指标包括甲状旁腺激素（parathyroidhormone，PTH）、血清肌酐（serum creatinine，Scr）、C反应蛋白（C-reactive protein，CRP）、红细胞（red blood cell，RBC）、血糖、血红蛋白（hemoglobin，Hb），并对上述指标的组间及组内差异进行统计分析。结果·与治疗前基线相比，试验组在治疗后 3 个月的牙周临床指标均得到改善（均P<0.05），且实验室指标CRP及Scr亦得到了改善（均P<0.05）。Pearson相关分析显示，伴牙周炎的尿毒症腹膜透析患者的牙周临床指标与实验室指标间存在一定相关性。结论·牙周基础治疗能够改善伴慢性牙周炎的尿毒症腹膜透析患者的牙周临床症状和全身状况。

关键词: 腹膜透析, 尿毒症, 牙周基础治疗, C反应蛋白

Abstract:

Objective · To investigate the clinical effect of periodontal initial therapy on uremic peritoneal dialysis patients with chronic periodontitis. Methods · Thirty-three uremic patients with chronic periodontitis who were treated with peritoneal dialysis in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine and Huashan Hospital, Fudan University were included. They were randomly divided into experimental group (16 cases, receiving both periodontal initial therapy and peritoneal dialysis treatment) and control group (17 cases, receiving peritoneal dialysis treatment). The periodontal clinical indexes including plaque index (PLI), bleeding index (BI), probing depth (PD) and clinical attachment loss (CAL), and laboratory indexes including parathyroidhormone (PTH), serum creatinine (Scr), C-reactive protein (CRP), red blood cell (RBC), blood glucose and hemoglobin (Hb) of the two groups were detected before and after treatment. The differences of the above indexes between groups and within groups were statistically analyzed. Results · Compared with baseline before treatment, the periodontal clinical indexes of the experimental group were improved at 3 months after treatment (all P<0.05), and the laboratory indexes Scr and CRP were also improved (both P<0.05). Pearson correlation analysis showed that there was a correlation between periodontal clinical indexes and laboratory indexes in uremic peritoneal dialysis patients with periodontitis. Conclusion · Periodontal initial therapy can improve the periodontal and systemic symptoms in uremic peritoneal dialysis patients with chronic periodontitis.

Key words: peritoneal dialysis, urinemia, periodontal initial therapy, C-reactive protein (CRP)

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