冠狀動脈鈣化與牙周病之間的關聯性

The Association between Coronary Artery Calcification and Periodontitis

吳政剛(Cheng-Kang Wu)

指導教授 ： 何坤炎

高雄醫學大學/口腔醫學院/牙醫學研究所碩士在職專班/碩士(2009年)

https://doi.org/10.6832/KMU.2009.00096

摘要

冠狀動脈鈣化與牙周病之間的關聯性
中文摘要
研究目的
本研究的目的是觀察冠狀動脈鈣化程度和臨床上評估牙周病的嚴重程度之間是否有關聯性的存在。

研究方法
患者沒有急性症狀，又不想接受心導管手術則建議作64切電腦斷層掃描。掃描的結果依據鈣化程度的不同換算成Agaston score。評估牙周病嚴重度的方式是計算附連喪失超過4mm的探測點佔全部的比例，有探測出血的探測點佔全部的比例，以及有附連喪失的牙齒佔全口的比例。

結果
無鈣化者定義為Agaston score等於0，Agaston score>0即為有鈣化。有鈣化者在年齡上 (61.46±9.74) 與無鈣化者(52.41±8.76) 比較有顯著的差異 (p=0.002)。在牙周病的評估方面，臨床附連喪失的情形在鈣化組有比較高的情形但是都未有顯著差異。
與牙周病的回歸分析，回歸直線的斜率顯著大於零。因此Agaston score的數值會隨著牙周病的嚴重度增加。(β=3.86, R2=0.15, p=0.0035)
進行多變項分析的結果，第一種模式包含年齡、牙周病、總膽固醇全部都還是跟Agaston score有顯著相關。接著除了年齡、牙周病、總膽固醇，再調整吸菸這個因素之後全部都變成不顯著，可見吸菸和其他三項皆有關聯。且牙周病的影響被調整後不顯著。

結論
冠狀動脈鈣化的程度與牙周病的嚴重程度有顯著的線性關係，調整過年齡、膽固醇的影響之後亦然。但是會受到吸菸的影響。兩者間的因果關係未清楚。

關鍵字：冠狀動脈鈣化，Agaston score，牙周病

關鍵字

冠狀動脈鈣化 ； Agaston score ； 牙周病

並列摘要

Abstract
Objective：
This study aims to evaluate the association between coronary artery calcification (CAC) evaluated by 64slice-CT and periodontal status clinically.

Materials & Methods：
Patients with subclinical symptom were advised to examine the coronary calcification by 64sliced-CT. The outcomes were showed as the Agaston score. The evaluation of periodontal condition was by probing of the pockets and clinical attachment levels were also recorded. The data are presented as the percentage of sites with clinical attachment level over 4mm, percentage of sites with bleeding on probing, and percentage of teeth with attachment loss.

Results：
The samples were grouped as subjects without CAC (Agaston score=0), and with CAC (Agaston score>0). The mean age of CAC group (61.46±9.74) is significantly higher than the non-CAC group (52.41±8.76). Furthermore, periodontal conditions are worse in the CAC group but the results are not significant.
We attempted to predict Agaston scores from severity of periodontitis using simple linear regression analysis. The slope of the regression line was significantly greater than zero (β=3.86, R2=0.15, p=0.0035)
The result of multivariate regression analysis showed that when adjusted for age and total cholesterol, periodontal condition is still associated with CAC. When adjusted for cigarette smoking , then age and periodontal condition are slightly influenced (p=0.06).
Conclusions：
The severity of CAC can be predicted from the extent of periodontitis. Poor periodontal condition can pose a slight risk to greater CAC, but other cofactors such as smoking must also be considered.
Key Words：Coronary artery calcification, Agaston score, Periodontitis

並列關鍵字

Coronary artery calcification ； Agaston score ； Periodontitis

參考文獻

參考文獻

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