[1]刘 芳,王 密,乔 柱,等.糖尿病伴慢性牙周炎患者口腔菌群变化及其与龈沟液炎症因子的相关性研究[J].现代检验医学杂志,2023,38(04):40-45+88.[doi:10.3969/j.issn.1671-7414.2023.04.007]
　LIU Fang,WANG Mi,QIAO Zhu,et al.Study on the Changes of Oral Flora and Its Correlation with Gingival Crevicular Fluid Inflammatory Factors in Diabetes Patients with Chronic Periodontitis[J].Journal of Modern Laboratory Medicine,2023,38(04):40-45+88.[doi:10.3969/j.issn.1671-7414.2023.04.007]
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糖尿病伴慢性牙周炎患者口腔菌群变化及其与龈沟液炎症因子的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
40-45+88
栏目:
论著
出版日期:
2023-07-15

文章信息/Info

Title:
Study on the Changes of Oral Flora and Its Correlation with Gingival Crevicular Fluid Inflammatory Factors in Diabetes Patients with Chronic Periodontitis
文章编号:
1671-7414（2023）04-040-07
作者:
刘 芳; 王 密; 乔 柱; 陈菁菁; 赵 虎
（保定市第一中心医院，河北保定 071000）
Author(s):
LIU Fang;  WANG Mi;  QIAO Zhu;  CHEN Jingjing;  ZHAO Hu
（the First Central Hospital of Baoding, Hebei Baoding 071000, China）
关键词:
糖尿病; 牙周炎; 口腔菌群; 龈沟液; 炎症因子
分类号:
R781.42；R446.5
DOI:
10.3969/j.issn.1671-7414.2023.04.007
文献标志码:
A
摘要:
目的　观察糖尿病伴慢性牙周炎患者口腔菌群变化，并分析其与龈沟液炎症因子的相关性。方法　选取保定市第一中心医院2022 年6 ～ 12 月收治的86 例糖尿病伴慢性牙周炎患者、88 例不伴糖尿病的慢性牙周炎患者分别记为A组和B 组，另于同期招募85 例健康志愿者记为对照组。三组均采用16S rDNA 高通量测序技术检测口腔菌群属水平的相对丰度，采用酶联免疫吸附法检测龈沟液炎症因子水平[ 包括超敏C 反应蛋白（high sensitivity C-reactive protein，hs-CRP）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白细胞介素-10（interleukin-10 ，IL-10）、白细胞介素-6（interleukin-6，IL-6）和白细胞介素-4（interleukin-4，IL-4）]。比较三组口腔菌群属水平相对丰度、多样性指数和龈沟液炎症因子水平；采用Pearson 法分析A 组口腔菌群属水平相对丰度与龈沟液炎症因子水平的相关性。结果　A 组乳杆菌属、双歧杆菌属、酵母菌属和肠球菌属水平相对丰度、龈沟液IL-10 水平均低于其余二组（t=4.657 ～ 37.617，均P＜ 0.05），B 组均低于对照组，差异均具有统计学意义（t=7.378 ～ 29.378，均P ＜ 0.05）；A 组卟啉单胞菌属、韦荣球菌属、普氏菌属、奈瑟菌属和密螺旋体属水平相对丰度、龈沟液hs-CRP，TNF-α，IL-6 和IL-4 水平均高于其余二组（t=2.945 ～ 39.822，均P ＜ 0.05），B 组均高于对照组，差异具有统计学意义（t=2.949 ～ 26.347，均P ＜ 0.05）。A组和B 组Shahnon 指数（5.44±0.48，5.35±0.36）均高于对照组（5.24±0.18），差异有统计学意义（t=3.599，2.528；P=0.000，0.012）。A 组乳杆菌属、双歧杆菌属、酵母菌属和肠球菌属水平相对丰度与龈沟液IL-10 水平均呈正相关（r=0.728 ～ 0.795，均P ＜ 0.05），与龈沟液hs-CRP，TNF-α，IL-6 和IL-4 水平均呈负相关（r=-0.867~-0.731，均P＜ 0.05）；A 组卟啉单胞菌属、韦荣球菌属、普氏菌属、奈瑟菌属和密螺旋体属水平相对丰度与龈沟液IL-10 水平均呈负相关（r=-0.854 ～ -0.730，均P ＜ 0.05），与龈沟液hs-CRP，TNF-α，IL-6 和IL-4 水平均呈正相关（r=0.705 ～ 0.892，均P ＜ 0.05）。结论　糖尿病伴慢性牙周炎患者口腔致病菌取代有益菌成为优势菌造成口腔菌群失调，龈沟液促炎症因子水平升高而抗炎症因子水平降低，较单纯慢性牙周炎患者改变更为显著，且在伴糖尿病的慢性牙周炎患者中口腔菌群属水平相对丰度与龈沟液炎症因子水平均有密切相关性。
Abstract:
Objective　To observe the changes of oral flora in diabetes patients with chronic periodontitis, and analyze the correlation between oral flora and inflammatory factors in gingival crevicular fluid(GCF) . Methods　86 diabetes patients with chronic periodontitis and 88 chronic periodontitis patients without diabetes who admitted to the First Central Hospital of Baoding from June 2022 to December 2022 were selected as A group and B group, and 85 healthy volunteers were recruited in the same period as the control group. 16S rDNA high throughput sequencing was used to detect the relative abundances of oral flora in the three groups, and the levels of inflammatory factors [including high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), interleukin-6 (IL-6) and interleukin-4 (IL-4)] in GCF were detected by enzyme linked immunosorbent assay. The relative abundances of oral flora, diversity index and the levels of inflammatory factors in gingival crevicular fluid were compared among the three groups, and the correlation between relative abundances of oral flora and the levels of inflammatory factors in gingival crevicular fluid in group A was analyzed by Pearson method. Results　The relative abundances of Lactobacillus，Bifidobacterium，Saccharomyces， Enterococcus and the level of IL-10 in gingival crevicular fluid in group A were lower than those in the other two groups (t=4.657 ～ 37.617, all P < 0.05), and those in group B were lower than those in the control group (t=7.378 ～ 29.378, all P < 0.05)，the differences were statistically significant，respectively. The relative abundances of Porphyromonas, Veronicus, Prevotella, Neisseria and Treponema and the levels of hs-CRP, TNF-α, IL-6 and IL-4 in gingival crevicular fluid in group A were higher than those in the other two groups (t=2.945 ～ 39.822, all P < 0.05), and those in group B were higher than those in the control group (t=2.949 ～ 26.347, all P < 0.05) ，the differences were statistically significant，respectively. The Shahnon index in group A and group B (5.44±0.48, 5.35±0.36) was higher than that in the control group (5.24±0.18), and the difference was statistically significant (t=3.599, 2.528, P=0.000, 0.012). The relative abundances of Lactobacillus，Bifidobacterium，Saccharomyces and Enterococcus in group A were positively correlated with the level of IL-10 in gingival crevicular fluid (r=0.728 ～ 0.795, all P < 0.05), which were negatively correlated with the levels of hs- CRP, TNF-α, IL-6 and IL-4 in gingival crevicular fluid (r=-0.867 ～ -0.731, all P < 0.05). The relative abundances of Porphyromonas, Veronococcus, Prevotellla, Neisseria and Treponema in group A were negatively correlated with the level of IL- 10 in gingival crevicular fluid (r=-0.854 ～ -0.730, all P < 0.05), which were positively correlated with the levels of hs-CRP, TNF-α, IL-6 and IL-4 in gingival crevicular fluid (r=0.705 ～ 0.892, all P < 0.05). Conclusion　Oral pathogenic bacteria in diabetes patients with chronic periodontitis replace beneficial bacteria as the dominant bacteria, and causing oral flora disorder, floratheir proportion is high, and the levels of pro-inflammatory factors in gingival crevicular fluid were increased, while the levels of anti-inflammatory factors were decreased, which were more significant than those in patients with simple chronic periodontitis. In the former, the relative abundances of oral flora in chronic periodontitis patients with diabetes mellitus were closely related to the levels of inflammatory factors in gingival crevicular fluid.

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备注/Memo

备注/Memo:
基金项目：保定市科技计划项目（2241ZF047）：牙周干预对伴糖尿病牙周炎患者的疗效观察及相关性分析。
作者简介：刘芳（1981-），女，硕士，主治医师，研究方向：口腔种植、口腔颌面外科，E-mail：liufanganhui01@163.com。
更新日期/Last Update: 2023-07-15