【作者】 覃文；

【导师】 李成章；

【作者基本信息】 武汉大学 ， 口腔临床医学， 2005， 硕士

【摘要】 研究背景: 近来,一系列的调查研究表明,伴随有全身慢性疾病的人群患牙周炎的风险增高,其中糖尿病患者的患病率和严重明显增加,但两者是否存在直接的因果关系还存在争议。同时,过去的研究显示,牙周炎和心血管疾病、中风有着一定联系,高血压是后两者较为确定的危险因素,其高危人群和牙周炎的高危人群有很多相同的特征,如年龄、吸烟等,在某些发病机制上也有着相似之处,但排除大量的混杂因素后,两者是否真正具有相关性,目前国内外都少有报道。 目的: 本研究通过对武汉市国家公务员的牙周状况及血糖、血压水平进行调查,探讨糖尿病、高血压与牙周炎的相关性。一方面为这一人群的口腔和全身疾病预防保健工作提供参考依据,另一方面也为今后进一步探索牙周炎的危险因素打下基础。 材料和方法: 本次研究的对象为武汉市的国家公务员,将该人群按汉阳、汉口、武昌三个地区进行地区分类,对每个地区的对象进行随机整群抽样。按纳入与排除标准审核最后进入研究的对象为458人。 对研究人群进行横断面调查。调查方法包括问卷和临床检查:调查问卷为相关情况的问题式调查;由患者在调查现场填写,部分不容易理解的问题由调查人员进行面对面采访。牙周状况的检查由武汉大学口腔医学院牙周粘膜科的两名专业学位型硕士研究生进行,两名同专业研究生进行记录和复核,并对其检查的各个步骤进行了标化,不具有统计学上的差异(kappa值>0.8);身体健康状况的检查结果由2004年度体检资料获得(所有体检均由武汉市的三级甲等医院进行)。根据血糖值的大小分为糖尿病患病组(空腹至少8小时后,血浆葡萄糖浓度≥7.0mmol/l)和对照组血浆葡萄糖浓度<7.0mmol/l);另根据血压值的大小分为高血压患病组(收缩压≥140mmHg,舒张压≥90mmHg)和对照组(收更多还原

【Abstract】 [Background] : An increased risk for periodontitis with diabetes mellitus has been reported ,even though the association between them has long been discussed with conflicting conclusions. Both of these diseases have a relatively high incidence in the older population as well as a number of common pathways in their pathogenesis. On the other hand, numerous reports indicate a higher incidence of periodontitis in population with hypertension compared to healthy controls, while other reports fail to show such a relationship. It has been demonstrated hypertension are the risk factors that are associated with heart disease, stroke and so on.It have been suggested that diabetes and hypertension ,which may be the risk factors,are associated with periodontitis.[Objective] : The purpose of this study is to identify the relationship between diabetes, hypertension and periodontitis, with investigation on the hyperglycemia, levels of blood pressure and periodontal conditions about officeholders in Wuhan city.[Material and methods] : Cross-sectional data were gathered from 458 subjects by means of quantitative questionnaire,clinical examination and patient records. The study sample are coming from officeholders in Wuhan city, which are classified as the districts of Hanyang, Hankou, Wuchang, sampled as the rule of random and all group. Questionnaire associated with general conditions; periodontal situations were examined by two postgraduates of clinical pattern of the periodontal department of the Stomatology Hospital of Wuhan University. The details of examination were standardized; the difference has no statistical significance. The data of physical condition were acquired from physical examination. The level of serum glucose≥ 7.0mmol/l is defined as diabetes, and systolic pressure ≥140mmHg or diastolic pressure ≥90mmHg is defined as hypertension. With the systemic software pack of managing dental data manufactured with Ruisi Software Company of Wuhan University, the data were recorded and managed. The results were analyzed with SPSS 11.5 software pack. In simple risk factor analysis, all variables were tested withnon-parametric method （ x z-test） in order to get risk factors（P<0.05）.Logistic regression analysis was run with all factors and it was done again after age was adjusted （classified as working group and retired group） in order to discuss the relationship between diatetes , hypertension and periodontitis.[Results] : The analysis of the cross-sectional survey data set confirms the previously reported significantly higher prevalence of periodontitis in diabetics than in non-diabetics （83.33% versus 59.24%）. The analysis of the data also shows that the prevalence of periodontitis in patients with hypertension is higher than that of normal blood-pressure patients （82.93% versus 56.38% in systolic pressure; 76.19% versus 57.75% in diastolic pressure） and that this difference is also statistically significant.The positive correlation of oral hygiene , tooth brushing,and diastolic pressure were found in simple risk factor analysis, but not in the last result of logistic regression analysis; but diabetes ,systolic, the background of education, smokong, and age in the last result.[Conclusions: ] In this study, diabetes and hypertension are associated with periodontitis. Systolic pressure has different effect on different age group, obvious effect on the group more than 60 years old, obesity is the risk factor for periodontitis in the all group. When the whole population was divided into two groups by age: 30^{working group}; 60⁷9（retired group）. The hypertension and diabetes have no obvious effect on the periodontitis on the group from 30 to 60 years old but effect on retired group.更多还原