目的 评估慢性牙周炎患者经牙周基础治疗前后的非刺激性全唾液、龈沟液及血清中基质金属蛋白酶-9 (MMp-9)水平,探讨其作为牙周炎诊断及预后标志物的可能性.方法 酶联免疫吸附试验(ELISA)检测20名牙周炎患者治疗前、后及20名健康人非刺激性全唾液、龈沟液及血清中MMP-9的水平,并记录牙周袋探诊深度(PD)、临床附着丧失(CAL)和出血指数(BI).结果 ①除CAL外,经牙周基础治疗6周后慢性牙周炎患者的临床指标明显改善[CAL治疗前(5.50±1.97) mm,治疗后(5.50±1.97) mm,P=1.000;PD治疗前(7.05±1.81) mm,治疗后(4.23±1.06) mm,P=0.000;BI治疗前3.75±0.44,治疗后0.20±0.41,P=0.000);②治疗后非刺激性全唾液、龈沟液及血清中MMP-9水平明显降低,与治疗前相比差异具有统计学意义[非刺激性全唾液MMP-9水平治疗前(22.89±5.28)ng/mL,治疗后(18.11±7.19) ng/mL,P=0.003;龈沟液MMP-9水平治疗前(41.80±2.90) ng/mL,治疗后(35.71±4.49) ng/mL,P=0.000;血清MMP-9水平治疗前(6.67±5.318) ng/mL,治疗后(2.47±2.713) ng/mL,P=0.004];③除血清外,牙周炎患者治疗前后的非刺激性全唾液和龈沟液中MMP-9水平仍高于健康对照组,其差异有统计学意义[非刺激性全唾液水平为(6.78±3.02)ng/mL,龈沟液为(30.20±3.64) ng/mL,与治疗前后比较P=0.000;健康对照组血清MMP-9水平(1.18±0.88) ng/mL,与治疗前、后比较P =0.004、P=0.055].结论 非刺激性全唾液中MMP-9的表达水平可能成为慢性牙周炎的检测指标之一,可能为临床诊治提供参考依据.
Objective To evaluate the MMP-9 levels in the unstimulated whole saliva (UWS),gingival crevicular fluid (GCF) and serum of patients with chronic periodontitis before and after the initial phase of periodontal treatment and to determine whether they are possible diagnostic and prognostic biomarkers for periodontitis.Methods Twenty patients with periodontitis and 20 healthy controls were included,and periodontal conditions (BI,PD,CAL) were assessed.The levels of MMP-9 in UWS,GCF and serum were measured by enzyme-linked immunosorbent assay before and after the treatment (BT and AT).Results ① In addition to CAL,the conventional periodontal treatment resulted in significant improvement in clinical parameters compared with before treatment.[CAL BT(5.50 ± 1.97) mm,AT (5.50 ± 1.97) mm,P =1.000 ; PD BT (7.05 ± 1.81) mm,AT(4.23 ± 1.06)mm,P =0.000;BI BT 3.75 ±0.44,AT 0.20 ±0.41,P =0.000]②MMP-9 levels in UWS,GCF and serum were significantly decreased six weeks after treatment[UWS BT(22.89 ± 5.28)ng/mL,AT(18.11 ±7.19) ng/mL,P =0.000;GCF BT(41.80 ±2.90) ng/mL,AT(35.71 ±4.49) ng/mL,P =0.000;serum BT(6.67 ± 5.318) ng/mL,AT (2.47 ± 2.713) ng/mL,P =0.004] ③In addition to serum,MMP-9 levels in UWS and GCF before and after the initial phase of periodontal treatment revealed significant increases compared with the control group[UWS of control group (6.78 ± 3.02) ng/mL,GCF (30.20 ± 3.64) ng/mL,P =0.000 ; serum of control group (1.18 ± 0.88) ng/mL,compared with BT and AT P =0.004,P =0.055].Conclusions The high expression of MMP-9 in unstimulated whole saliva is likely to become indicators in chronic periodontitis,and may provide a reference for clinical diagnosis and treatment.