摘要目的 评价定期龈上洁治和龈下刮治对2型糖尿病患者牙周健康及龈沟液白介素6水平的影响.方法 采用随机、对照、盲法设计,将37例2型糖尿病伴牙周炎患者分为基础治疗组(牙周基础治疗)13例、龈上洁治组(龈上洁治)11例及空白对照组13例,比较其治疗后6周、3个月和6个月时临床指标包括探诊深度(PD),附着丧失(AL),改良出血指数(mBI),菌斑指数(PLI)、龈沟液(GCF)量及龈沟液IL6水平的变化.结果 基础治疗组各项指标在各时间点均较基线显著降低(P＜0.05),龈上洁治组呈现下降趋势,其中3个月时PD减少有统计学意义(⊿=0.36 mm,P＜0.05).基础治疗组、龈上洁治组6个月时GCF减少量显著高于对照组增加(0.96 μl＞0.03 μl mm＞-0.02 μl,P＜0.05).结论 定期牙周机械治疗可改善糖尿病患者牙周健康及龈沟液IL-6水平.

abstractsObjective To evaluate the effectiveness of periodontal mechanical therapy on periodontal health and interleukin-6 (IL-6) levels in gingival crevicular fluid (GCF) in type 2 diabetic patients with chronic periodontitis. Methods GCF samples were obtained with filter papers in first molar sites from 37 type 2 diabetic patients with chronic periodontitis. The randomized controlled and blinded clinical trial with a duration of six months was designed to compare effects between three groups of professional mechanical tooth cleaning (PMTC), i.e. coronal scaling (group Ⅱ) with periodontal initial therapy (group Ⅰ) and without clinical therapy (control group). The clinical periodontal index such as probing depth (PD), attachment loss (AL), modified bleeding index (mBI) and bacteria plaque index (PLI) were obtained with a Williams type periodontal probe. Laboratory examination including GCF volume, concentrations and total amounts of IL-6 in GCF were detected with ELISA method. Results Significantly decreasing trends of PD, AL, mBI, GCF volume and total amounts of IL-6 were observed in group Ⅰin all test period. The group Ⅱ had a significant reduction of PD at the third month as compared with baseline (⊿=0.36 mm, P＜0.05), and the other figures showed descending trends but didn′t present statistical significances. At the end of study, the group Ⅰand Ⅱ had significant reductions of GCF volume compared with increases of control group (0.96 μ1＞0.03 μ1mm＞-0.20 μ1, P＜0.05). Conclusions The sequential periodontal supra- and sub- gingival scaling has definitive effects on periodontal health improvement and on reducing the IL-6 level in GCF in type 2 diabetic patients.