冠心病和慢性牙周炎相关性研究

张源明; 钟良军; 何秉贤; 聂晶; 王璇; 李文超

Abstract

张源明,钟良军,何秉贤,聂晶,王璇,李文超.冠心病和慢性牙周炎相关性研究[J].Chinese journal of Epidemiology,2006,27(3):256-259

冠心病和慢性牙周炎相关性研究

Study on the correlation between coronary heart disease and chronic periodontitis

Received:July 21, 2005

DOI：

KeyWord: 冠心病慢性牙周炎病因学危险因素

English Key Word: Coronary heart disease Chronic periodontitis Etiology Risk factors

FundProject:新疆维吾尔自治区自然科学基金资助项目(200321105)

Author Name	Affiliation
ZHANG Yuan-ming	Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
ZHONG Liang-jun	新疆医科大学第一附属医院口腔科
HE Bing-xian	Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
NIE Jing	新疆医科大学第一附属医院口腔科
WANG Xuan	新疆医科大学第一附属医院口腔科
LI Wen-chao	Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China

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Abstract:

目的探讨冠心病与慢性牙周炎的相关关系。方法 515例“胸部不适”的患者, 经病史和选择性冠状动脉造影结果分为冠心病组277例、对照组238例, 对所有受检者均进行牙周状况的检查, 测量全口牙周袋深度和牙周附着丧失, 慢性牙周炎的诊断参照Armitage推荐的标准, 同时对冠心病其他常见的危险因素进行比较。结果冠心病组慢性牙周炎患病率为54.9%, 而对照组仅为29.9%, 两者差异有统计学意义(P<0.001)。单因素分析发现冠心病组患者甘油三酯、血糖、白细胞计数、高血压及吸烟的发生率均显著高于对照组(P<0.01~0.001); 而高密度脂蛋白胆固醇(HDL-C)则显著低于对照组(P<0.01)。多因素非条件logistic回归分析, 仅慢性牙周炎、糖尿病、高血压及HDL-C与冠心病显著相关。慢性牙周炎和冠心病不仅有统计学上的关联, 且具有明显的剂量反应关系, 即随着牙周炎程度的加重患冠心病的危险也增大(P<0.001), 且随牙周炎程度的加重, 罹患冠心病的程度亦进一步加重。结论慢性牙周炎可能是冠心病的独立危险因素, 慢性牙周炎可能增加冠心病发生的风险程度, 且随着牙周炎程度的加重,罹患冠心病的严重程度也增大。

English Abstract:

Objective To explore the correlation between angiographically-defined coronary heart disease (CHD) and chronic periodontitis (CP). Methods 277 cases with CHD (case group) and another 238 with no agiographic evidence of CHD(control group) were compared on their traditional cardiovascular risk factors,as :oral health status and probing depth,clinical attachment level,gingival recession,as well as number of missing teeth. Other related risk factors of CHD were included in a stepwise logistic regression analysis. Results Data from univariate analysis showed that there was significant difference in CP,plasma triglyceride,high density lipoprotein cholesterol (HDL-C),fast glucose,white blood count,hypertension and smoking between patients with CHD and those with out CHD( P < 0.01-0.001). Multiple factorial logistic regression analysis showed that CP, hypertension,diabetes mellitus,HDL2C were strongly correlated with the incidence of CHD. Significant dosage-effective response was also found in the relationship between CP and CHD ( P< 0.001). Further studies also suggested that the severity of CP paralleled the severity of CHD. Conclusion The results indicated that CP might serve as an independent risk factor of CHD and significantly enhance the risk and severity of CHD. Our study suggested that the elimination of probable risk factors in oral cavity was indispensable during the process of the prevention of CHD in order to prevent acute coronary events.

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