摘要目的 了解伴2型糖尿病牙周炎患者龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalis,Pg)菌毛蛋白A(fimbria protein A,FimA)基因型的分布情况,探讨糖尿病加重牙周破坏的可能机制.方法 纳入北京大学口腔医学院·口腔医院牙周科中老年中重度牙周炎患者80例,其中伴2型糖尿病40例(伴糖尿病牙周炎组),无系统性疾病者40例(单纯牙周炎组).对两组患者分别进行问卷调查、全口牙周检查及血生化检查,滤纸条法取前牙和后牙各一个位点的龈下菌斑形成集合菌斑样本,PCR法检测样本内Pg及其FimA基因型,比较两组受试者Pg及其FimA基因型的检出差异.结果 伴糖尿病牙周炎组菌斑指数[2.35(0.58)]显著高于单纯牙周炎组[1.64(0.76)](P＜0.05),其他各项牙周临床指标差异均无统计学意义(P＞0.05);伴糖尿病牙周炎组龈下菌斑Pg检出率[50％(20/40)]与单纯牙周炎组[60％ (24/40)]相比差异无统计学意义(P＞0.05),但FimAⅡ型检出百分比[80％(16/20)]显著高于后者[42％(10/24)] (P＜0.05).结论 伴2型糖尿病牙周炎患者较无系统性疾病牙周炎患者更易感染毒力较强的FimA Ⅱ型Pg.

abstractsObjective To investigate the distribution differences of Porphyromonas gingivalis(Pg) FimA genotypes between periodontitis patients with and without type 2 diabetes for a better understanding of the relationship between diabetes and periodontitis.Methods Questionnaires and detailed periodontal examinations(6 sites per tooth) were conducted in 80 subjects with moderate-severe chronic periodontitis in the Department of Periodontology, Peking University School and Hospital of Stomatology.There were 40 type 2 diabetic patients and 40 systemicly healthy patients enrolled respectively.The periodontal parameters including plaque index(PLI), probing depth(PD), bleeding index(BI), attachment loss(AL) by 6 sites per tooth and numbers of missing teeth were also recorded.Pooled subgingival plaque samples using pocket method with Whatman No3 filterpaper were collectedat each of the 6 sites from one incisor and one molar.Pg and its FimA genotype distributions were investigated using DNA extrctedfrom plaque samples by PCR.Results Diabetic patients had a significantly higher score of PLI[2.35(0.58) vs 1.64(0.76), P＜0.05] , while rest of periodontal indexes observed(PD, BI and AL) did not differ significantly between diabetic patients and systemicly healthy controls(P＞0.05).The detection rate of Pg did not show statistically significant difference between the two groups(50％ vs 60％, P＞0.05).However, the proportion of FimA Ⅱ was significantly higher in diabetic group than systemicly healthy group(80％ vs 42％, P＜0.05).Conclusions Type 2 diabetic patients were prone to be infected by highly virulent strains of Pg: FimA Ⅱ Pg.