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慢性牙周炎患者血液及龈沟液中干扰素γ、白介素4水平与复发性自然流产的关系

Relationship between recurrent spontaneous abortion and the level of interferon-γ and interleukin-4 in peripheral blood and gingival crevicular fluid of patients with chronic periodontitis

摘要:

目的 检测复发性自然流产(recurrent spontaneous abortion,RSA)孕妇外周血及其龈沟液中白介素4(interleukin-4,IL-4)、干扰素γ(interferon-γ,IFN-γ)的含量并进行比较,探讨牙周炎是否会引起体液免疫失调,引起孕妇宫腔内免疫环境向T辅助细胞1型(T-helper 1,Th1)漂移并引发流产.方法 检查RSA孕妇50例(孕5至28周)(RSA组)和足月待产孕妇40例(孕39至41周)(对照组)的牙周状况,收集其龈沟液和静脉血,对其进行口腔卫生宣教,酶联免疫吸附测定法检测龈沟液和静脉血中IFN-γ、IL-4的水平.结果 RSA组9例患牙周炎,患病率为18% (9/50),对照组5例患牙周炎,患病率为13% (5/40),两组牙周炎的患病率差异有统计学意义(P <0.05);RSA组的探诊深度、附着丧失及出血指数均显著高于对照组(P<0.05).RSA组孕妇龈沟液及静脉血中IFN-γ含量[分别为(52.98±17.56)、(27.79±3.59) ng/L]均显著高于对照组[分别为(25.25±7.93)、(18.39±2.65) ng/L],P<0.05;RSA组孕妇龈沟液及静脉血中IL-4的含量[分别为(15.43±1.77)、(15.88 ±0.95) ng/L]均显著低于对照组[(19.62±4.04)、(22.98±4.30) ng/L],P<0.01.相同组内静脉血与龈沟液中IFN-γ、IL-4的含量均呈正相关关系(r值均>0.8,P<0.001).结论 RSA孕妇患牙周炎的几率较高,牙周组织中IFN-γ、IL-4浓度的改变会进一步引发静脉血中IFN-γ、IL-4的浓度改变,使Th1-Th2平衡向Th1漂移;RSA孕妇与其患牙周炎存在相关性.

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abstracts:

Objective To investigate the relationship between recurrent spontaneous abortion (RSA) and the level of interferon-γ(IFN-γ) and interleukin-4 (IL-4) in peripheral blood and gingival crevicular fluid of patients with chronic periodontitis.Methods Fifty pregnant women with recurrent spontaneous abortion(gestational age: 5-28 weeks) and 40pregnant women (gestational age: 39-41 weeks)were included and their periodontal status was examined.The level of IFN-γ and IL-4 in gingival crevicular fluid and peripheral blood was detected by enzyme-linked immunosorbent assay.Results Nine RSA women and 5 in control group had periodontitis.The prevalence of periodontitis in RSA group was 18% (9/50) and 13% (5/40) in the control group(P <0.05).The probing depth,attachment loss and bleeding index in RSA group were higher than those in the control group(P <0.05).The level of IFN-γwas (52.98 ± 17.56) ng/L in gingival crevicular fluid of RSA group and (25.25 ± 7.93) ng/L in control group(P < 0.01).The level of IL-4 was (15.43 ± 1.77) ng/L in gingival crevicular fluid of RSA group and (19.62 ± 4.04) ng/L in control group (P <0.01).The content of IFN-γwas (27.79 ± 3.59) ng/L in peripheral blood of RSA group and (18.39 ±2.65) ng/L in control group(P <0.05).The content of IL-4 was (15.88 ± 0.95) ng/L in peripheral blood of RSA group and (22.98 ± 4.30) ng/L in control group (P < 0.001).The content of cytokines in gingival crevicular fluid and peripheral blood in the same group was positively related (r > 0.8,P < 0.001).Conclusions Pregnant women of RSA have a higher chance of getting periodontitis.The change in the level of cytokines in periodontal tissue could result in excursion of maternal intrauterine immune environment to T-helper 1 (Th1).Periodontitis was related to RSA.

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