摘要
目的研究胸腺基质淋巴细胞生成素(TSLP)、缺氧诱导因子1α(HIF-1α)、核因子-κB受体活化因子配体(RANKL)在义齿修复后种植体周围炎(PI)患者龈沟液中的表达及意义。方法回顾性选取2019年8月至2023年8月大同市第五人民医院收治的义齿修复患者86例作为研究对象,根据术后3个月是否发生PI将患者分为预后良好组(n=61)和预后不良组(n=25)。比较两组患者的临床资料及术前龈沟液TSLP、HIF-1α及RANKL水平,采用多因素Logistic回归分析对龈沟液TSLP、HIF-1α及RANKL水平与义齿修复患者术后发生PI的关系进行分析,采用受试者操作特征(ROC)曲线分析TSLP、HIF-1α及RANKL水平对义齿修复患者的预后评估价值。结果两组患者临床资料(性别、年龄、病程、义齿种植原因及种植颗数)比较,差异均无统计学意义(P>0.05)。预后良好组患者的龈沟液中TSLP、HIF-1α、RANKL水平分别为(122.57±11.30)ng/L、(417.79±115.43)ng/mL、(116.02±13.45)pg/μL,均明显低于预后不良组[(138.93±12.70)ng/L、(576.55±177.60)ng/mL、(133.24±15.69)pg/μL],差异均有统计学意义(P<0.05)。Logistic回归分析义齿修复患者预后,结果显示龈沟液中TSLP水平升高、HIF-1α水平升高和RANKL水平升高是义齿修复患者术后发生PI的独立危险因素(OR=1.119,95%CI:1.048~1.195;OR=1.007,95%CI:1.002~1.013;OR=1.065,95%CI:1.016~1.117;P<0.05)。ROC曲线分析龈沟液中TSLP、HIF-1α、RANKL水平预测义齿修复患者预后的价值,结果显示曲线下面积(AUC)值分别为0.833、0.786和0.809。其中,RANKL具有最高的特异度(0.852),而HIF-1α具有最高的敏感度(0.800),具有较好的预测价值(P<0.05)。结论龈沟液中TSLP、HIF-1α、RANKL水平升高是义齿修复患者术后并发PI的独立危险因素,且均具有较高的预测义齿修复患者预后的价值。
Objective To investigate the expression and significance of thymus stromal lymphocyte opoietin(TSLP),hypoxia-inducing factor 1α(HIF-1α)and nuclear factor-κB receptor activating factor ligand(RANKL)in the crevicular fluid of patients with periimplantitis(PI)after dentural restoration.Methods A total of 86 patients with denture restoration admitted to the Fifth People's Hospital of Datong from August 2019 to August 2023 were selected as the study objects.According to whether PI occurred three months after surgery,the patients were divided into good prognosis group(n=61)and poor prognosis group(n=25).The clinical data of the two groups were compared,and the levels of TSLP,HIF-1αand RANKL in the preoperative creval fluid were compared.Multivariate Logistic regression analysis was used to analyzed the relationship between gingival crevicular fluid.TSLP,HIF-1αand RANKL levels and postoperative PI in patients with denture restoration.The prognostic value of TSLP,HIF-1αand RANKL in patients with denture restoration was analyzed by receiver operating characteristic(ROC)curve.Results There were no statistically differences in clinical data(gender,age,course of disease,reason for implant and number of implants)between the two groups(P<0.05).The levels of TSLP,HIF-1αand RANKL in the good prognosis group were(122.57±11.30)ng/L,(417.79±115.43)ng/mL and(116.02±13.45)pg/μL,which were significantly lower than those in the poor prognosis group[(138.93±12.70)ng/L,(576.55±177.60)ng/mL,and(133.24±15.69)pg/μL],the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis of the prognosis of patients with denture restoration showed that the level of TSLP and HIF-1αin gingival crevicultural fluid increased and HIF-1αincreased and elevated RANKL levels were independent risk factors for PI in patients with denture restoration(OR=1.119,95%CI:1.048-1.195;OR=1.007,95%CI:1.002-1.013;OR=1.065,95%CI:1.016-1.117;P<0.05).ROC curve analysis of the levels of TSLP,HIF-1αand RANKL in gingival creval fluid predicted the prognosis of patients with prosthesis restoration,and the results showed that the area under the curve(AUC)values were 0.833,0.786 and 0.809,respectively.Among them,RANKL had the highest specificity(0.852),while HIF-1αhad the highest sensitivity(0.800),had good predictive value(P<0.05).Conclusion The elevated levels of TSLP,HIF-1αand RANKL in the creval fluid are independent risk factors for postoperative PI in patients with denture restoration,and all of them have high prognostic value in patients with denture restoration.
作者
张云霞
杨娜
姚莉
符建青
王全智
ZHANG Yun-xia;YANG Na;YAO Li(Department of Orthodontics and Prosthetics,The Fifth People's Hospital of Datong,Datong Shanxi 037009,China;Department of Stomatology,The Second People's Hospital of Shanxi Province,Taiyuan Shanxi 030001,China;Department of Dentistry,Hospital of Stomatology,Shanxi Medical University,Taiyuan Shanxi 030001,China)
出处
《临床和实验医学杂志》
2024年第15期1656-1659,共4页
Journal of Clinical and Experimental Medicine
基金
山西省自然科学基金项目(编号:201901D111202)。
关键词
义齿修复术
牙种植体
缺氧诱导因子1
α亚基
胸腺基质淋巴细胞生成素
核因子-ΚB受体活化因子配体
种植体周围炎
龈沟液
Prosthodontics
Dented implants
Hypoxia inducible factor 1,alpha subunit
Thymic stromal lymphopoietin
Nuclear factor-κB receptor activation factor ligand
Peri-implant inflammation
Gingival crevicular fluid
