牙周相關疾病與冠狀動脈疾病風險的相關性之研究

A Study on Exploring Correlation between Periodontal Diseasees and risk of Coronary Artery Disease

王培子(Pei-Tzu Wang) ； 黃純德(Shun-Te Huang) ； 顏雅音(Yea-Yin Yen) ； 黃曉靈(Hsiao-Ling Huang) ； 康沛倫(Pei-Leun Kang) ； 馬光遠(Guang-Yuan Mar) ； 邱春旺(Chuen-Wang Chiou) ； 謝耀東(Yao-Tung Hsieh)

《Taiwan Journal of Oral Medicine Sciences》 27卷2期 (2011/08) Pp. 94-107

https://doi.org/10.7059/TJOMS.201108.0031

摘要

齒齦炎是牙周疾病的一種，是指支持牙齒周圍的組織發炎，或遭受破壞稱牙周病，慢性牙周組織發炎是細菌感染牙周組織所引起的慢性感染性疾病，當細菌不斷進入血液中，可能引發人體免疫反應，以致體內長期處於發炎狀態，進而增加動脈硬化的風險，引發相關心血管疾病！目前已經有越來越多的證據顯示，由慢性牙周組織炎所引起的感染及慢性發炎反應，可能和粥狀動脈硬化有關。牙周疾病和粥狀動脈硬化有許多的致病病理機轉是相似的。近年來也已被證實可能會藉由牙周致病原的直接或間接因素對冠狀動脈心臟疾病（冠心病）的發生造成影響。心臟病中最常見的是冠心病，成因為脂肪和鈣質沈積在心臟的冠狀動脈管壁內，形成動脈硬化斑塊，使血管狹窄，當動脈鈣化與斑塊太過嚴重時，心臟肌肉便會缺氧、壞死，稱為狹心症或心肌梗塞。研究結果顯示，男性的高密度脂蛋白顯著大於女性，三酸甘油脂男性大於女性，男性的鈣化指數有較高的趨勢。不同鈣化指數組別的年齡、C反應蛋白及缺齒有顯著差異。不同牙結石評分組別在白血球及缺齒有顯著差異。男性在白血球顯著大於女性，缺齒男性顯著小於女性。不同年齡層與、血糖、醣化血色素、膽固醇總量、高密度脂蛋白、低密度脂蛋白、總量與高密度比、缺齒、鬆動齒、齒齦炎、鈣化指數，都有顯著差異。調整過變項之後，在性別、年齡、白血球、高密度脂蛋白、低密度脂蛋白及齲齒對鈣化指數有顯著影響。年齡每增加一歲鈣化指數增加的風險會多出0.13倍、白血球會少於0.81倍（P＝0.046）、高密度脂蛋白會少於0.95倍（P＝0.011）、低密度脂蛋白會多出0.02倍（P＝0.011）及齲齒會多出0.44倍（P ＝0.041）對鈣化指數有顯著影響。

關鍵字

齒齦炎 ； 冠心病

並列摘要

Atherosclerotic complications, including coronary heart disease and stroke, are the main cause of human death. up to date, it is assumed that atherosclerosis is an inflammatory vascular condition, and certain infectious disease may provoke atherosclerosis and possibly would be one of its risk factors. Chronic perceived, perceived as an infectious disease induced by bacteria, is regarded as one of the major cause of oral infection and has also been proved to contribute to the pathophysiology of atherosclerosis via direct or indirect invasion of periodontal pathogens in recent years. The correlation of these two diseases will be discussed and be elucidated their possible links. We try to high light the debated points of exploring correlation between gingivitis and risk of coronary artery disease and laboratory investigation in the case. 184 cases from admitted to our health exammin center due to health exam..drug history and the clinical history of risk factors, such as diabetes mellitus, hypertension, smoking and hyperlipidemia, were recorded from detailed chart review by a staff physician. Periodontal examination including tooth condition(caries, filling ,crown ,bridge missing, removable denture, gingival ression, cervical abrasion, indication for extraction) and dental calculus, gingivitis, soft tissue condition, periodontal examination and laboratory investigation including triglyceride, cholesterol, HDL-C,T.C./HDL, LDL-C, glucose, HbA1c, CRP, WBC. The results were analyzed by statistical software 15.0. The study show no difference in age, CRP, white count, bilirubin, TG, glucose, cholesterol, HDL, LDL, gingivitis. Study revealed significant difference in gender. Example: The HDL in female was greater than male. The triglycerin in male was greater than female. The calcification index in the male had the greater predominance. A statistically significant relationship was found the severe of gingivitis, the higher of calcification index. Chronic periodontitis is a possible trigger of chronic inflammation. We try to describe the potential role of various inflammatory as well as immunologic factors that may play a role in periodontitis as a possible risk factor for atherosclerosis. As the oral cavity is one potential source of infection, it is wise to try to ensure that any oral disease is minimized. This may be of significant benefit to cardiovascular health and enables members of the oral health team to contribute to their patients' general health.

並列關鍵字

gingivitis ； coronary heart disease