【摘要】 目的 探讨慢性牙周炎(CP)患者血清miR-181a-5p、miR-126-5p、miR-148a-3p表达水平及其与牙周临床指标的相关性。方法 选取自2022年4月至2024年4月西安交通大学口腔医院第一门诊部收治的125例CP患者纳入CP组，另选取128例于本院体检且口腔健康的成年人作为健康组。再根据牙周临床指标将CP患者分为轻度组(n=64)与中重度组(n=61)。应用实时荧光定量PCR测定血清miR-181a-5p、miR-126-5p、miR-148a-3p相对表达水平。应用Pearson法分析CP患者血清miR-181a-5p、miR-126-5p、miR-148a-3p水平与牙周临床指标、炎性因子的相关性。应用多因素Logistic回归分析CP患者病情严重程度的影响因素。受试者工作特征曲线分析血清miR-181a-5p、miR-126-5p、miR-148a-3p对CP患者病情严重程度的诊断价值。结果 CP组miR-126-5p、miR-148a-3p表达水平高于健康组，miR-181a-5p表达水平低于健康组；CP组菌斑指数(PLI)、龈沟出血指数(SBI)、探诊深度(PD)、牙周附着丧失(AL)、白细胞介素(IL)-6、IL-17、IL-10、肿瘤坏死因子α(TNF-α)水平均高于健康组，差异均有统计学意义(P<0.05)。中重度组血清miR-126-5p、miR-148a-3p、IL-6、IL-17、IL-10、TNF-α、PLI、SBI、PD、AL均高于轻度组，miR-181a-5p低于轻度组，差异均有统计学意义(P<0.05)。血清miR-126-5p、miR-148a-3p表达水平与PLI、SBI、PD、AL、IL-6、IL-17、IL-10、TNF-α呈正相关，miR-181a-5p表达水平与PLI、SBI、PD、AL、IL-6、IL-17、IL-10、TNF-α呈负相关(P<0.05)。多因素Logistic回归分析结果显示，血清miR-126-5p、miR-148a-3p是CP患者病情进展的独立危险因素，miR-181a-5p是CP患者病情进展的保护因素(P<0.05)。血清miR-181a-5p、miR-126-5p、miR-148a-3p均对CP患者病情严重程度具有良好的诊断价值，三者联合诊断曲线下面积优于各指标单独诊断(P<0.05)。结论 CP患者血清miR-126-5p、miR-148a-3p呈高表达，miR-181a-5p呈低表达，且与牙周临床指标密切相关，参与疾病进展，三者联合可作为CP病情进展的诊断指标。更多还原

【Abstract】 Objective To investigate the expression levels of miR-181a-5p, miR-126-5p, miR-148a-3p in serum of patients with chronic periodontitis(CP)and their correlation with periodontal clinical indicators.Methods A total of 125 CP patients admitted to Department of First Outpatient Clinic in College of Stomatology, Xi′an Jiaotong University from April 2022 to April 2024 were included in CP group, and another 128 adults with oral health who underwent physical examination in our hospital were selected as health group.According to periodontal clinical indexes, CP patients were divided into mild group(n=64)and moderate and severe group(n=61).The relative expression levels of miR-181a-5p, miR-126-5p and miR-148a-3p in serum were determined by real-time fluorescence quantitative polymerase chain reaction.Pearson method was used to analyze the correlation between serum miR-181a-5p, miR-126-5p, miR-148a-3p levels and periodontal clinical indicators and inflammatory factors in CP patients.Multivariate logistic regression was used to analyze the factors affecting the severity of CP patients.The diagnostic value of serum miR-181a-5p, miR-126-5p and miR-148a-3p in the severity of CP patients was analyzed by receiver operating characteristic curve.Results The expression levels of miR-126-5p and miR-148a-3p in CP group were higher than those in healthy group, and the expression levels of miR-181a-5p were lower than those in healthy group.The levels of plaque index(PLI),gingival creval bleeding index(SBI),probing depth(PD),loss of periodontal attachment(AL),interleukin(IL)-6,IL-17,IL-10 and tumor necrosis factor α(TNF-α) in CP group were higher than those in healthy group, with statistical significance(P<0.05).Serum miR-126-5p, miR-148a-3p, IL-6,IL-17,IL-10,TNF-α,PLI,SBI,PD and AL in moderate and severe group were higher than those in mild group, and miR-181a-5p was lower than those in mild group, with statistical significance(P<0.05).The expression levels of serum miR-126-5p and miR-148a-3p were positively correlated with PLI,SBI,PD,AL,IL-6,IL-17,IL-10 and TNF-α.The expression level of miR-181a-5p was negatively correlated with PLI,SBI,PD,AL,IL-6,IL-17,IL-10 and TNF-α(P<0.05).Multivariate Logistic regression analysis showed that serum miR-126-5p and miR-148a-3p were independent risk factors for disease progression in CP patients, and miR-181a-5p was a protective factor for disease progression in CP patients(P<0.05).Serum miR-181a-5p, miR-126-5p, and miR-148a-3p all had good diagnostic value for the severity of CP patients, and the area under the combined diagnosis curve of the three was better than that of each index alone(P<0.05).Conclusion The expression of miR-126-5p and miR-148a-3p in the serum of CP patients is high, and the expression of miR-181a-5p is low, which is closely related to periodontal clinical indicators and involved in disease progression.The combination of the three can be used as diagnostic indicators for the progression of CP.更多还原