摘要
目的评估HIV+牙周炎患者的免疫状态和龈沟液中肿瘤坏死因子α与牙周临床指标的相关性,以期为临床提供指导。方法对20例HIV+牙周炎患者计数其血液CD4+T淋巴细胞,对共计120颗指数牙进行牙周检查,包括:菌斑指数、出血指数、附着水平和牙周探诊深度。按免疫状态分组:重度免疫抑制组(CD4<200个/mm3)5例30颗牙;中度免疫抑制组(200≤CD4≤500个/mm3)13例78颗牙;轻度免疫抑制组(CD4>500个/mm3)2例12颗牙。用放射免疫方法检测龈沟液中TNF-α。组间比较采用Mann-Whitney秩和检验,CD4计数和牙周参数的相关性采用偏相关分析,TNF-α与牙周临床参数的关系采用Spearman相关分析。结果结果非正态分布,采用中位数和四分位间距[M(Q)]表示。中度免疫抑制组的BI值为[3.00(2.00)],显著高于重度免疫抑制组[2.00(1.25)]和轻度免疫抑制组[2.00(1.00)](P<0.0167);轻度免疫抑制组的TNF-α总量为[0.04(0.02)]pg,显著低于重度免疫抑制组组[0.06(0.04)]pg和中度免疫抑制组[0.06(0.05)]pg(P<0.0167);3组间的TNF-α浓度、牙周探诊深度和附着水平差异均无统计学意义(P>0.0167)。中、重度免疫抑制组的CD4计数和出血指数有相关性,偏相关系数分别为0.657(P<0.001)、-0.369(P=0.001)。轻度免疫抑制组CD4计数和出血指数无相关性(P=0.625)。TNF-α总量和各项牙周临床指标间均正相关(P<0.05)。结论 HIV+牙周炎患者的牙周炎症状态与免疫状态有关,中度免疫抑制者的牙周炎症表现最为明显,其龈沟液中TNF-α水平与牙周破坏程度呈正相关。
Objective To investigate the correlation of CD4 ＋ T lymphocyte count and tumor necrosis factor alpha（TNF-α） in gingival crevicular fluid （GCF） with periodontal status in HIV-positive patients with periodontitis. Methods Twenty subjects were selected according to inclusion criteria. The plasmatic CD4 ＋ T lymphocytes were counted. All the individuals were divided into three groups, severe immunosuppression group （CD4 〈 200celL/mm3 ） , moderate immunosuppression group （ 200 ≤ CD4 ≤ 500cell/mm3 ） and mild immunosuppression group （ CD4 〉 500eell/mm3 ）. Clinical measurements, including plaque index （PLI）, bleeding index（ BI）, attachment level（AL） and probing depth（PD）, were recorded. GCF samples were collected from 120 index teeth by sterile paper strips. GCF TNF-α levels were determined by radioimmunoassay. Mann-Whitney was used to compare the periodontal indexes and TNF-α levels among the three groups. Partial correlations and Spearman correlations were applied to analyze the correlation of CD4 count and GCF TNF-α with periodontal status. Results BI value was [ 3.00 （ 2.00 ） ] in moderate immunosuppression group and higher than those in mild immunosuppression group and severe immunosuppression group. Total TNF-α was 0. 04 （0. 02 ） pg in mild immunosuppression group and lower than those in severe immunosuppression group and moderate immunosuppression group （P 〈0.0167）. But the TNF-α concentration and PD and AL among the three groups were not significantly different （P 〉 0.0167 ）. The correlation was observed between CD4 count and BI in the moderate and severe immunosuppression groups. Total TNF-α and the clinical measurements were positively correlated （ P 〈 0.05 ）. Conclusion The periodontal status in patients with HIV ＋ was related to the immune status, and the periodontitis was most obvious in the patients with moderate immune suppression. The level of TNF- in gingival crevicular fluid was positively correlated with the degree of per
出处
《北京口腔医学》
CAS
2017年第3期131-135,共5页
Beijing Journal of Stomatology
关键词
肿瘤坏死因子
人免疫缺陷病毒
牙周炎
龈沟液
CD4计数
Tumor necrosis factor
Human immunodeficiency virus
Periodontitis
Gingival crevicular fluid
CD4 count
