摘要为观察牙周基础治疗对糖尿病患者牙周状况及糖化血红蛋白(HbA1c)的影响,收集2011年1月至2013年12月在福建省立医院内分泌科门诊、病房及体检中心就诊的2型糖尿病合并慢性牙周炎患者102例,其中男58例,女44例,平均年龄(45±9)岁.按随机数字法分为两组,干预组51例,给予糖尿病和牙周炎的系统治疗,对照组51例,仅予降血糖治疗.牙周临床检查指标为探诊深度(PD),牙周附着丧失(CAL),龈沟液中的天冬氨酸转氨酶(AST),血糖控制指标为HbA1c.牙周治疗组在经龈上洁治3个月和龈下刮治3个月后,记录固定牙位同一位点牙周指标及相应时期的HbA1c.无牙周治疗组记录固定牙位同一位点牙周炎指标及相应时期HbA1c.组间差异采用独立样本t检验,计数资料比较采用卡方检验,P<0.05为差异有统计学意义.龈上洁治后各组牙周状况及血糖状况无明显变化.龈下刮治后3个月,与对照组相比,干预组PD(1.9±0.6) mm、CAL(1.8±0.7)mm、AST(364±105) mmol/L均低于对照组(2.6±0.6)mm、(2.2±0.6)mm、(532±112)mmol/L均有明显下降(t=2.438、3.375、3.591,均P<0.05),同时干预组HbA1c(7.3 ± 1.9)%也较对照组(8.1 ± 1.9)%明显下降(χ2=2.831,P<0.05).结果表明,龈上洁治结合龈下刮治不仅能显著改善2型糖尿病患者的牙周组织炎症状况,同时可能对患者的血糖控制有所改善.

abstractsTo evaluate the effects of periodontal basic therapy on hemoglobin (HbA1c) and periodontal status of diabetic patients, a total of 102 patients with type 2 diabetes mellitus combined chronic periodontitis, which included male 58 and female 44 with average age(45±9)yrs, were enrolled from January 2011 to December 2013. The patients were randomly divided into two groups. The intervention group of 51 patients received hypoglycemic therapy and systemic periodontal therapy. The control group only received hypoglycemic therapy. Periodontal clinical examination indexes included the probing depth(PD), clinical attachment loss(CAL) and aspartate transaminase(AST) in gingival crevicular fluid. Glycemic control was measured as glycosylated hemoglobin(HbA1c). After supragingival scaling for 3 months and subgingival curettage for 3 months, periondontal indexes of fixed tooth position in the same site and the corresponding HbA1c were recorded in periodontal treatment group. Same indexes were recorded in the control group, too. Independent sample t test was used for the difference between groups. Chi square test was used for the comparison of categorical data. P<0.05 was considered as statistically significant difference. After subgingival curettage for 3 months, PD(1.92 ± 0.62)mm, CAL(1.79 ± 0.72)mm, AST(364.0 ± 105.2)mmol/L, in intervention group were significantly lower than those in the control group:PD(2.56±0.65)mm, CAL (2.15± 0.57)mm, AST (532.3 ± 112.5)mmol/L (t=2.438, 3.375, 3.591, all P<0.05). In addition, HbA1c (7.3 ± 1.9)%of intervention group was much lower than that (8.1 ± 1.9)% of control group (χ2=2.831, P<0.05). The results suggest supragingival scaling combined with subgingival curettage not only alleviated significantly inflammation of periodontal tissues, but also improved glycemic control of type 2 diabetic patients.