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[摘要]目的观察口腔专项干预改善急性冠脉综合征（ACS）合并牙周疾病患者心绞痛的疗效。方法将ACS合并中、重度慢性牙周疾病患者75例随机分为观察组（38例）和对照组（37例）。两组患者均接受常规抗ACS治疗，观察组另接受口腔专项干预，且分别在入选后3天内及干预6个月时进行疗效指标检测：①口腔及牙周健康指标；②外周血及龈沟液（GCF）处炎性标识指标（IL_1β、IL_6和TNF_α）；③心绞痛疗效问卷（西雅图心绞痛调查量表，SAQ）。结果干预前两组患者各类口腔及牙周相关指标接近，干预6个月后观察组的牙周袋深度（PD）、牙周附着丧失（CAL）、牙齿松动度（M）、龈沟出血指数（SBI）及简化口腔卫生指数（OHI_S）均明显好于干预前及对照组同期结果，差异有统计学意义（均P<0.05～0.01）；干预前两组患者外周血及GCF处炎性细胞因子IL_1β、IL_6及TNF_α表达水平分布接近，干预6个月后观察组上述各项炎性指标均显著低于干预前及对照组同期结果，差异有统计学意义（均P<0.05～0.01）；干预前两组首次心绞痛疗效比较中，SAQ量表各项因子评分和SAQ总分分布接近，干预6个月后观察组多数因子评分及SAQ总分均明显高于干预前和对照组同期评估结果，差异有统计学意义（均P<0.01～0.05）。结论口腔专项干预可以明确改善ACS合并牙周疾病患者口腔及牙周健康指标、外周血与GCF处炎性标识指标及心绞痛疗效指标。
[关键词]急性冠脉综合征；牙周病；口腔干预；牙周健康指标
中图分类号：R541.4文献标识码：A文章编号：1009_816X（2014）05_0366_04
doi：10.3969/j.issn.1009_816x.2014.05.04Effects of Specialized Oral Intervention on Angina Treatment in Patients with ACS and Peridontal Disease. LI Ping， ZHANG Li， LI Anna， et al. Department of Cardiology， Shenyang 202 Hospital of Chinese PLA， Shenyang 110003， China
[Abstract] Objective To observe the effects of specialized oral intervention on angina treatment in patients with acute coronary syndrome （ACS ） and periodontal disease. Methods There were sequential 75 patients suffered with ACS and chronic periodontal disease， and they were randomly divided into 2 groups： Observation group （n=38） and contrast group （n=37）. Both groups accepted the conventional treatment and nursing care of anti_ACS， in addition， the observation group accepted specialized oral intervention. And the 2 groups were detected the healing effect indexes separately in 3 days and 6 months respectively： ① oral and periodontal health index，② peripheral blood and GCF inflammatory index（IL_1β， IL_6 and TNF_α， ③ questionnaire of anginal healing effect （Seattle angina symptoms questionnaire， SAQ）.Results The oral and periodontal indexes of both groups from the first detection are close， while after 6 months， the observation group had better indexes of PD， CAL， M， SBI and OHI_S， compared with its first detection and the indexes of contrast group in the same period， the difference is significant （P<0.05）. The peripheral blood and GCF inflammatory indexes of IL_1β，IL_6 and TNF_α of the 2 groups are close， after 6 months， each inflammatory indexes of observation group is apparently lower than that in its first detection and contrast group in the same period， the difference is significant （P<0.05）. In the first comparison of anginal healing effect of the 2 groups， each factor score and final score of SAQ are close， while after 6 months， most SAQ factor scores and final score of observation group are much higher than its first detetion and the contrast group in the same period， the difference is significant （P<0.05）.Conclusions Specialized oral interventions can definitely improve indexes such as the oral and peidontal health， inflammatory identification of peripheral blood and GCF， and angitina therapeutic effects of patients with ACS and periodontal disease.
[关键词]急性冠脉综合征；牙周病；口腔干预；牙周健康指标
中图分类号：R541.4文献标识码：A文章编号：1009_816X（2014）05_0366_04
doi：10.3969/j.issn.1009_816x.2014.05.04Effects of Specialized Oral Intervention on Angina Treatment in Patients with ACS and Peridontal Disease. LI Ping， ZHANG Li， LI Anna， et al. Department of Cardiology， Shenyang 202 Hospital of Chinese PLA， Shenyang 110003， China
[Abstract] Objective To observe the effects of specialized oral intervention on angina treatment in patients with acute coronary syndrome （ACS ） and periodontal disease. Methods There were sequential 75 patients suffered with ACS and chronic periodontal disease， and they were randomly divided into 2 groups： Observation group （n=38） and contrast group （n=37）. Both groups accepted the conventional treatment and nursing care of anti_ACS， in addition， the observation group accepted specialized oral intervention. And the 2 groups were detected the healing effect indexes separately in 3 days and 6 months respectively： ① oral and periodontal health index，② peripheral blood and GCF inflammatory index（IL_1β， IL_6 and TNF_α， ③ questionnaire of anginal healing effect （Seattle angina symptoms questionnaire， SAQ）.Results The oral and periodontal indexes of both groups from the first detection are close， while after 6 months， the observation group had better indexes of PD， CAL， M， SBI and OHI_S， compared with its first detection and the indexes of contrast group in the same period， the difference is significant （P<0.05）. The peripheral blood and GCF inflammatory indexes of IL_1β，IL_6 and TNF_α of the 2 groups are close， after 6 months， each inflammatory indexes of observation group is apparently lower than that in its first detection and contrast group in the same period， the difference is significant （P<0.05）. In the first comparison of anginal healing effect of the 2 groups， each factor score and final score of SAQ are close， while after 6 months， most SAQ factor scores and final score of observation group are much higher than its first detetion and the contrast group in the same period， the difference is significant （P<0.05）.Conclusions Specialized oral interventions can definitely improve indexes such as the oral and peidontal health， inflammatory identification of peripheral blood and GCF， and angitina therapeutic effects of patients with ACS and periodontal disease.