非手術性牙周治療對於類風濕性關節炎患者血清發炎指數及自體免疫指數的影響：病例系列報告

類風溼性關節炎與牙周病皆為慢性發炎疾病，並共享類似的免疫發炎模式，造成了骨頭及周圍組織的破壞，使功能受損；除流行病學的統計顯示出兩種疾病有高度相關性，過去文獻也指出牙周病可能影響類風溼性關節的血清檢驗數值及臨床症狀嚴重度。本文提出4位同時患有類風濕性關節炎及慢性牙周病的患者，在不改變類風濕性關節炎的現況治療下，比較非手術性牙周治療前後的血清中各項發炎及免疫指數的變化，以期瞭解非手術性牙周治療是否有助於改善病人血清自體免疫抗體及發炎因子。研究結果顯示抗環瓜胺酸肽抗體（anti-cyclic citrullinated peptide antibody, ACPA）和類風濕因子（Rheumatoid factor, RF）這兩項與類風濕性關節炎最相關的自體免疫指數，分別在牙周治療前，皆有2位病人數值為異常，而在非手術性牙周治療後，皆有明顯的下降。

關鍵字

非手術性牙周治療；類風濕性關節炎；牙周病；抗環瓜胺酸肽抗體；類風濕因子

並列摘要

Rheumatoid arthritis (RA) and chronic periodontitis are the most common forms of chronic inflammatory disease. They share a common immuno-inflammatory profile and have been found to demonstrate remarkably similar patterns of soft and hard tissue destruction. RA pathogenesis is complex and there seems to be a combination of genetic, environmental, hormonal, and infectious co-factors involved in the disease. RA patients have been reported to have more severe periodontitis than healthy controls. This case series consists of four RA patients with chronic periodontitis who were referred from the Department of Rheumatology of National Taiwan University Hospital. Each patient received nonsurgical periodontal therapy without changing their RA treatment or medicines. We evaluated the effect of such non-surgical periodontal therapy on serum autoimmune antibody titers (anti-cyclic citrullinated peptide antibody, ACPA; and rheumatoid factor, RF) and on various inflammatory marker levels. The results show that non-surgical periodontal therapy is able to improve serum ACPA and RF levels in RA patients with periodontitis. Further case-control studies are needed to validate the effect of such non-surgical periodontal therapy on RA clinical symptoms and signs, as well as on serum makers.

並列關鍵字

non-surgical periodontal therapy ； rheumatoid arthritis ； chronic periodontitis ； ACPA ； RF

國際替代計量

非手術性牙周治療對於類風濕性關節炎患者血清發炎指數及自體免疫指數的影響：病例系列報告

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