慢性牙周炎与冠心病相关性的初步研究

分析对比100例冠心病患者与100例体验职工有无慢性牙周炎,探讨牙周炎患者与冠心病的相关性。冠心病患者牙周炎的发病率明显高于一般人群,慢性牙周炎与冠心病之间存在一定的相关性。     

T.f和P.i在慢性牙周炎和冠心病伴慢性牙周炎患者龈下菌斑中的分布

目的:采用PCR技术,比较福赛斯坦纳菌(T.f)、伴放线放线杆菌(P.i)在慢性牙周炎(CP)和冠心病伴慢性牙周炎(CHD+CP)患者菌斑中的分布,探讨其检出率与两者相关性的关系.方法:32例研究对象,CP62例,CHD+CP70例,收集龈下菌斑,提DNA,检测T.f、P.i分布.结果:T.f检出率分别是66.67%、71.43%、92.5%和85.71%、70.37%、80.95%;结果有差异(Z=-2.982,P=0.003﹤0.05).P.i检出率分别是:22.23%、42.86%、47.5%和0.00%、14.81%、4.77%.在CHD+CP组中,T.f与P.g有相关性,(r=-0.306,P=0.012﹤0.05).结论:T.f与冠心病有相关性.     

影响慢性牙周炎预后的因素分析

目的寻找影响慢性牙周炎预后的危险因素,根据危险因素制定相应策略,提高生活质量。方法在我院明确诊断为慢性牙周炎的患者中,选择100例食欲较好,牙周炎进展缓慢,未见明显并发症的患者为对照组,同期从中选择100例饮食差、体重减轻至少5kg以上、自述生活质量明显降低的患者作为牙周炎组,采集两组患者的一般资料、疾病史、生活习惯、口腔检查资料,通过单因素分析和Logistic多元回归模型分析得出影响慢性牙周炎患者发病的危险因素。结果单因素分析显示,牙周炎组偏嚼、偏食、不正规刷牙方式、刷牙时间不够、磨牙、吸烟、饮酒、负性生活事件、糖尿病、心脏病、牙龈出血、龈下菌斑的发生率显著高于对照组(P<0.05),牙石指数、软垢指数、知识得分、基础治疗差的发生率显著高于对照组(P<0.05);Logistic回归分析显示,吸烟、饮酒、冠心病、龈下菌斑、牙石指数、软垢指数、知识得分、基础治疗为独立危险因素(P<0.05)。结论影响慢性牙周炎预后的危险因素有吸烟、饮酒、冠心病、龈下菌斑、牙石指数、软垢指数、知识得分、基础治疗。     

慢性牙周炎对冠心病的影响

近年来，国外部分流行病学研究、体外实验和动物实验显示，口腔感染尤其是慢性牙周炎与冠心病有关。我们对216例冠心病患者进行了慢性牙周炎对冠心病影响的研究。     

不可忽视慢性牙周炎

牙周病何以发生 牙周病的发病原因是多方面的，牙菌斑、细菌及其代谢产物是牙周疾病发生的必要条件，并在一些引起牙周病的危险因素共同作用下，导致牙周病的发生。比较明确的危险因素包括口腔卫生情况、性别、年龄、种族、社会经济状况、吸烟、紧张和压力、遗传因素、某些全身疾病的影响、某些微生物的感染等。有些危险因素可通过医生的干预、改变个人行为、加强健康教育等，清除或减弱其影响，而有些（年龄、性别、遗传因素）则为不可变因素。     

慢性牙周炎EBV-1和HHV-6感染及危险因素分析

目的通过临床实践,分析慢性牙周炎EBV-1和HHV-6感染及其危险因素。方法选取60位慢性牙周炎患者为研究对象,将其EBV-1与HHV-6阳性率与牙周健康者相比。然后通过病例-对照研究与logistic多因素回归分析,找出EBV-1与HHV-6感染的影响因素。结果慢性牙周炎患者EBV-1与HHV-6的阳性感染率明显高于牙周健康者。结论慢性牙周炎患者的EBV-1和HHV-6感染率较高。EBV-1感染与患者的年龄、CP以及牙周袋深度有关;而HHV-6感染与患者的年龄与CP有关。     

甘氨酸龈喷砂治疗老年冠心病并慢性牙周炎疗效

目的冠心病并发慢性牙周炎老年患者应用甘氨酸龈喷砂治疗效果情况分析。方法选取2018年6月-2019年6月本院诊治冠心病并发慢性牙周炎老年150例患者资料,按随机数表分两组,对照组予超声洁治联合抛光,研究组予甘氨酸龈喷砂,分析两组疼痛度、咀嚼改善时间、炎症指标及牙周指标。结果研究组疼痛度(3.03±0.79)分及咀嚼改善时间(5.05±1.26)d比对照组少(P <0.01);且研究组IL-6(62.38±17.46) pg/mL、CRP(2.03±0.55) mg/L比对照组少(P<0.01);研究组牙周指标评估指标优于对照组(P <0.01)。结论冠心病并发慢性牙周炎老年患者应用甘氨酸龈喷砂治疗,能有效缓解疼痛度,缩短咀嚼功能的改善时间,降低炎症因子指标。     

高尿酸血症与冠心病的相关性研究

目的 探讨高尿酸血症与冠心病的关系,为冠心病的防治提供依据.方法 对德州市城区参加社会保险健康查体职工98 800人的查体资料进行整理分析.结果 高尿酸血症组男性和女性冠心病构成比均明显高于非高尿酸血症组,差异均有统计学意义(x2值分别为7.921,410.00,P＜0.01).分层危险度估计表明,高尿酸血症组女性罹患冠心病的风险是男性的3倍(男性OR=1.218,女性OR=3.712).趋势x2检验结果显示,随血尿酸水平的升高,冠心病构成比呈上升趋势(x2=68.764,P＜0.01).结论 冠心病构成比与血尿酸水平相关,高尿酸血症可能与冠心病发生有关.     

冠心病猝死及其与人群心血管病危险因素水平相关性的研究

本文对1985至1989五年累计2 990 816人群中的冠心病猝死(SCHD)发生率及其与人群心血管病危险因素水平的相关性进行探讨。结果表明SCHD总发生率为12/10万(按1964年标准人口计算标化率为9.5/10万,按1982年人口计算标化率为11.1/10万)。SCHD与人群平均血压水平、高血压患病率、血清总胆固醇水平、体重指数、吸烟率、ECG异常检出率、心血管病患病率均呈正相关(r=0.79~0.99,P<0.01);与血清高密度脂蛋白水平呈负相关(r=-0.81,P<0.01)。     

慢性牙周病与冠心病的Meta分析

目的探讨慢性牙周疾病与冠心病之间的关联性。方法利用医学文献搜索引擎收集1996—2011年与此相关的病例对照研究和队列研究文献,应用Meta分析软件对数据进行定量分析。结果 5篇病例对照研究和3篇队列研究被纳入,病例对照研究合并的OR值为3.00,95%可信区间为1.41～6.38,队列研究合并的RR值为1.53,95%可信区间为1.21～1.90。结论慢性牙周病有增加冠心病的危险性。     

C反应蛋白水平与传统冠心病危险因素分析

目的了解江苏省人群C反应蛋白（CRP）的水平与传统冠心病（CHD）危险因素的关系。方法通过“江苏省多代谢异常和代谢综合征综合防治研究”资料，比较高敏C反应蛋白（hs—CRP）（hs—CRP：1～2．99mg／L和≥3mg／L）与传统CHD危险因素：体重指数（BMI）、吸烟、高血压、高血糖、高胆固醇、高三酰甘油、低高密度脂蛋白胆固醇、体力活动缺乏等的关系。结果高hs—CRP罹患率均随血压、血糖、胆固醇、三酰甘油、BMI、吸烟、体力活动（无、轻、中、重）增加而增高，但当hs-CRP（1-2．99mg／L）时，传统CHD危险因素中大部分未表现出显著联系；随着Framingham心脏积分（5个危险因素）合并数量增加，高hs-CRP呈明显的等级性变化趋势；logistic回归分析表明，hs—CRP（≥3mg／L）时，BMI、三酰甘油、高血压、高密度脂蛋白胆固醇、吸烟、血糖的OR值均有统计学意义，但hs—CRP（1～2．99mg／L）时，传统CHD危险因素的OR估计值大部分无统计学意义；男性中60．98％和女性中59．02％的高CRP可以归因于传统CHD危险因素。结论传统CHD危险因素与hs—CRP水平关系密切，目前在临床上、人群研究中根据CRP水平的高低判断CHD风险的实际意义值得进一步探讨。     

The relationship between education and risk factors for coronary heart disease

In nine samples of adult populations (2707 males and 2871 females, aged 20–59 years) we studied the relationship between educational level and several lifestyle factors at risk for coronary heart disease (CHD), (i.e., smoking, alcohol consumption, dietary fat intake, sedentary behaviour at work and leisure) and the association between education and certain CHD risk factors (i.e., total cholesterol, HDL-cholesterol, triglycerides, systolic and diastolic blood pressure, body mass index). The data were analyzed separately in samples from North, Central and Southern Italy. The results show that educational level is often associated to the lifestyle factors considered here. This association was positive for both men and women for physical activity at leisure and work stress and only for women with respect to smoking. It was negative for both men and women for alcohol consumption and physical activity at work and for men only for cigarette smoking. The age-adjusted mean levels of the CHD risk factors show some significant differences among subjects with different educational levels, which were not always the same for the three geographical areas. This was with the exception of BMI in females, which appears negatively associated to education in all areas. These differences decreased after adjustments were made for daily cigarette smoking, wine consumption and dietary fat intake. Education seems to play a determining role in lifestyle, however its direct and indirect effects on some major CHD risk factors are somewhat different in areas at different socio-economic conditions.     

Comparison of risk factors for coronary heart disease in Dresden and Münster

Trend analyses based on WHO statistics for average life expectancy, age-standardized cardiovascular (CVD) morbidity and mortality show significant differences between the former German Democratic Republic (GDR) and the former Federal Republic of Germany (FRG). To investigate whether this is due to a different prevalence of cardiovascular risk factors, the Dresden Cardiovascular Risk and Nutrition (DRECAN) study was conducted using the complete methodology of the Prospective Cardiovascular Münster (PROCAM) study, i.e., the same methods and strict quality controls, with an exchange of specimens between both laboratories. The results were compared with those of an adjusted subpopulation of the PROCAM study.Even before unification there were only small differences in lipoprotein profiles between West and East Germany, 10 months after unification these differences were minimal. The survey does not sufficiently explain the differences in CHD morbidity and mortality between Western and Eastern Germany. Further analyses of the nutritional aspects will show whether the change, in available foodstuffs after unification has led to substantially changed nutritional habits, and whether this might explain some of the results. DRECAN-Team; G. Assmann^2,3, S. Bergmann¹, P.H. Epping², T. Fraidt¹, J. Heinrich², W. Jaross¹, H. Martin², S. Petersen², M. Sandkamp³, B. Schottmann¹, H. Schulte², B. Siegert¹, H. Thulin¹ & U. Wahrburg²     

不同性别冠心病患者危险因素及冠状动脉病变特点分析

目的 分析不同性别冠心病(CHD)患者危险因素及其冠状动脉(冠脉)病变的特点.方法 纳入2009年1月至2011年1月在解放军总医院经冠脉造影确诊为CHD患者共3765例(男性2661例,女性1104例),收集患者各类临床资料及冠脉病变数据.根据患者年龄和性别进行分层,应用logistic回归模型分析CHD传统危险因素及冠脉病变的特点.结果 (1)女性发病年龄迟于男性,且合并CHD传统危险因素多;女性随年龄增长,吸烟的比例下降,血脂异常和糖尿病的比例显著升高.男性患者中,吸烟是最常见的危险因素.(2)性别间比较的logistic回归模型提示,糖尿病可显著增加女性罹患CHD的风险(OR=2.05,95％CI:1.49～ 2.81,P＜0.001),而吸烟则可明显增加男性罹患CHD的风险(OR=9.27,95％CI:7.68～11.19,P＜0.001).(3)随着年龄增长,女性患者冠脉病变支数增加,血管狭窄程度加重;而男性冠脉病变程度无随年龄增长而变化的趋势.结论 不同性别的CHD患者在不同年龄段具有不同的危险因素和冠脉病变特点.糖尿病和血脂异常似对女性冠脉病变的影响较大,而吸烟则对男性影响较大.     

The prediction of coronary heart disease in different population samples

Two population samples of men aged 46–65 years were examined for the measurement of some cardiovascular risk factors and followed up for 6.5 years. The two groups were: 1) 3338 men belonging to occupational groups examined in Rome (ROG) in 1979–81 and 2) 1543 men belonging to two demographic samples of rural areas located in northern and central Italy (IRA) examined in 1965. In men free from previous myocardial infarction the rate of fatal coronary events was 18.0 in the ROG group and 17.5 per 1000 in the IRA group.Five established risk factors (age, systolic blood pressure, serum cholesterol, cigarette consumption and body mass index) were used in a multivariate model for predicting coronary deaths.The coefficients of the multiple logistic function were similar in the two populations group. However, when the IRA coefficients were applied to the ROG factors, they predicted 43 events instead of 58 (under-estimation of 26%; p < 0.05), whereas the ROG coefficients predicted 31 events instead of 26 in the IRA sample (over-estimation of 19%; p = n.s.).A model which included the pool of the two populations and a dummy-variable for the identification of each of them, suggested that being a member of the ROG group is accompained, everything else being equal, by an extra risk of 26%.Corresponding author.     

民航飞行员冠心病危险因素与冠状动脉病变程度的相关性分析

目的 探讨飞行员冠心病的危险因素与冠状动脉病变严重程度之间的关系.方法 研究对象为2002-2011年在中国民用航空局民用航空医学中心进行健康检查鉴定的飞行员40人.均为男性,年龄在38～60岁,均行冠状动脉造影(CAG)检查,30人确诊为冠心病,10人确诊为冠状动脉粥样硬化症.结果 ①将40名飞行员分为冠心病组和冠状动脉粥样硬化组.冠脉硬化组较冠心病组年轻(P＜0.05),体重指数(BMI)冠脉硬化组和冠心病组均＞24,收缩压、舒张压、低密度脂蛋白脂固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(rG)、空腹血糖以及危险因素数目在两组间无统计学差异.②30名冠心病飞行员按照冠状动脉病变支数分为1支病变组(17人),2支病变组(9人)和3支病变组(4人),LDL-C水平在3支病变组明显升高(P＜0.05),BMI、收缩压、舒张压、HDL-C、TG、空腹血糖以及危险因素数目在3组间差异无统计学意义.结论 飞行员冠心病严重程度与年龄、BMI、LDL-C有关,与危险因素数目无关.     

血管紧张素转换酶基因多态性与冠心病危险因素的关系

目的 探讨血管紧张素转换酶（ＡＣＥ）基因多态性与冠心病危险因素的关系。方法 应用聚合酶链反应技术和遗传学方法,测定１５９名汉族正常人、１４８例冠心病患者的ＡＣＥ基因插入／缺失（Ｉ／Ｄ）多态性频率,并调查冠心病患者经内危险因素。结果①ＡＣＥ基因型分布与冠心病患者的年龄、性别、体重指数（ＢＭＩ）、收缩压、舒张压、总胆固醇（ＴＣ）、甘油三酯（ＴＧ）、低密度脂蛋白（ＬＤＬ）、高密度脂蛋白（ＨＤＬ）、ＨＤＬ     

餐后血糖水平与冠心病发生的相关性

目的 探讨餐后血糖水平与冠心病发生的相关性.方法 选择血糖水平异常并已行冠状动脉造影的患者85例,按血糖水平将患者分为三组:空腹血糖调节受损(IFG)组28例、糖耐量减低(IGT)组29例及糖尿病(DM)组28例,观察各组冠心病发生率及冠状动脉病变程度,分析三组患者C反应蛋白(CRP)、颈动脉内膜中层厚度(CIMT)、血脂、血压、体重指数(BMI)的变化及与冠心病危险因素的相关性.结果 IGT组和DM组冠心病发生率[分别为79.3%(23/29)、85.7%(24/28)]明显高于IFG组[53.6%(15/28)](P＜0.01),DM组冠心病发生率高于IGT组,但差异无统计学意义(P＞0.05).IGT组和DM组2支病变、3支病变发生率均高于IFG组(P＜0.01),DM组2支病变、3支病变发生率高于IGT组,但差异无统计学意义(P＞0.05).IGT组、DM组CRP、CIMT、BMI、三酰甘油(TG)、收缩压(SBP)较IFG组明显升高(P＜0.01或＜0.05),高密度脂蛋白胆固醇(HDL-C)较IFG组明显降低(P＜0.01);DM组CRP、TG、SBP较IGT组升高(P＜0.05),其他指标比较差异无统计学意义(P＞0.05);相关性分析表明,IGT组和DM组餐后2 h血糖与CRP、CIMT、BMI、TG呈显著正相关(P＜0.05或＜0.01),与HDL-C呈显著负相关(P＜0.05或＜0.01).结论 餐后高血糖与冠心病的发生、发展有密切关系,对于IGT患者应尽早予以干预治疗,可有效预防心血管事件的发生.

Abstract：

Objective To investigate the correlation between the level of postprandial blood glucose (PBG)and the incidence of coronary artery disease(CAD). Methods Eighty-five patients performed coronary angiography with abnormal blood glucose levels were divided into 3 groups according the blood glucose levels: impaired fasting glucose(IFG)group(28 cases), impaired glucose tolerance(IGT)group(29cases)and diabetes mellitus(DM)group(28 cases). The detection rate and the extent of CAD were observed. The risk factors of CAD in 3 groups such as C-reactive protein(CRP),carotid artery intima-media thickness(CIMT), blood lipids, blood pressure, body mass index(BMI)and the correlation with CAD were analyzed. Results Sixty-two cases were confirmed CAD by coronary angiography. The incidence rate of CAD in IGT group[79.3%(23/29)]and DM group[85.7%(24/28)]was significantly higher than that in IFG group[53.6%(15/28)](P ＜ 0.01). The incidence rate of CAD in DM group was higher than that in IGT group, but there was no significant difference(P ＞ 0.05). The incidence rate of two-lesion and three-lesion in IGT group and DM group were significantly higher than those in IFG group(P＜ 0.01). The incidence rate of two-lesion and three-lesion in DM group were higher than those in IGT group, but there was no significant difference(P＞0.05). The levels of CRP, CIMT, BMI, triacylglycerol(TG)and systolic blood pressure(SBP)were higher and HDL-C was lower in IGT group and DM group than those in IFG group(P ＜ 0.01 or ＜ 0.05).The levels of CRP,TG and SBP were higher in DM group than those in IGT group(P＜0.05). Correlation analysis showed, in IGT group and DM group,2 h PG had significantly positive correlation with CRP, CIMT,B MI, TG(P＜0.05 or＜0.01), and had significantly negative correlation with HDL-C(P＜0.05 or ＜0.01).Conclusions PBG is closely related with the development of CAD.IGT patients should be intervened as early as possible, which can be effective in preventing cardiovascular events.     

Inter-cohort differences in coronary heart disease mortality in the 25-year follow-up of the seven countries study

Sixteen cohorts of men aged 40–59 years at entry were examined with the measurement of some risk factors and then followed-up for mortality and causes of death for 25 years. These cohorts were located in the USA (1 cohort), Finland (2), the Netherlands (1), Italy (3), the former Yugoslavia (5), Greece (2), and Japan (2), and included a total of 12,763 subjects.Large differences in age-adjusted coronary heart disease (CHD) death rates were found, with extremes of 45 per 1000 in 25 years in Tanushimaru, Japan, to 288 per 1000 in 25 years in East Finland. In general, higher rates were found in the US and Northern European cohorts as compared to the Southern European and Japanese cohorts. However, during the last 10 years of follow-up large increases of CHD death rates were found in some Yugoslavian areas. Out of 5 measured entry characteristics treated as age-adjusted levels (serum cholesterol, systolic blood pressure, cigarette smoking, body mass index and physical activity at work), only serum cholesterol was significant in explaining cohort differences in CHD death rates.Over 50% of the variance in CHD death rates in 25 years was accounted for by the difference in mean serum cholesterol. This association tended to decline with increasing length of follow-up, but this was due to the great changes in mean serum cholesterol in the two Jugoslavian cohorts of Velika Krsna and Zrenjanin. When these two cohorts were excluded the association increased with time.Changes in mean serum cholesterol between year 0 and 10 helped in explaining differences in CHD death rates from year 10 onward.It can be concluded that this study suggests that mean serum cholesterol is the major risk factor in explaining cross-cultural differences in CHD.