目的:本研究通过观察白介素18(IL-18)在慢性牙周炎(CP)及类风湿关节炎(RA)患者血清及龈沟液中浓度的改变探讨类风湿性关节炎与牙周炎的关系。方法采用双免疫酶联法检测16例健康志愿者、20例牙周炎患者、21例类风湿关节炎患者、26例牙周炎伴类风湿关节炎患者血清及牙龈沟液中IL-18的含量。记录四组患者的牙龈出血指数( BI)、牙周探诊深度(PD)、临床附着丧失(CAL)水平。结果龈沟液中IL-18水平RA+CP组(221.83±43.38) pg/mL高于CP组(198.00±37.72) pg/mL,RA组(138.10±23.16) pg/mL和HP组(135.12±27.11) pg/mL且与各组之间差异均具有统计学意义(p<0.05);血清中IL-18水平在CP+RA组(321.02±260.57) pg/mL,CP组(220.60±228.37) pg/mL,RA组(186.29±253.03)pg/mL,HP组(169.56±143.82) pg/mL间呈现降低趋势,CP+RA组与HP组差异具有统计学意义。结论类风湿性关节炎与牙周炎之间可能存在相关性,而IL-18可能是联系两者的生物学基础之一。
Objective To explore the relationship between rheumatoid arthritis ( RA) and chronic periodontitis ( CP) by observing the role of IL-18 in serum and gingival crevicular fluid ( GCF) of patients with CP and RA. Methods 83 subjects were selected and divided into four groups:16 healthy participants as the control group, 20 patients with CP, 21 patients with RA, and 26 patients with CP and RA. The serum and GCF levels of IL-18 were measured by enzyme-linked immunosorbent assay ( ELISA) , and clinical perio-dontal parameters including bleeding index ( BI) , probing depth( PD) , and clinical attachment loss( CAL) were examined. Results The IL-18 levels in GCF of patients with CP and RA [(221. 83±43. 38) pg/mL] were significantly higher than those in the CP group [(198. 00±37. 72) pg/mL], RA group [(138. 10±23. 16) pg/mL] and the control group [(135. 12±27. 11) pg/mL] (P<0. 05). Serum levels of IL-18 in the CP and RA group [(321. 02±260. 57) pg/mL], CP group [(220. 60±228. 37) pg/mL], RA group [(186. 29±253. 03) pg/mL] and HP group [(169. 56±143. 82) pg/mL] showed a decreasing trend. Only in CP and RA group, the serum levels of IL-18 were significantly higher than those in the control group (P<0. 05). Conclusion IL-18 can be one of the bio-logical foundations that correlates chronic periodontitis and rheumatoid arthritis.