A Clinical Study On The Correlation Between Periodontitis And Coronary Heart Disease And Their Mechanism

Purpose:To study the correlation between periodontitis and coronary heart disease (CHD).Methods:1. 124 cases of CHD in-patients were enlisted in case group, while 43 cases with no evidence of CHD were randomly collected as the control group. Conducted the questionnaire research and the examinations of patients'periodontal condition on patients of CHD. And CHD case group were separated into two groups among whom whether suffered the periodontitis at the same time or not. Then the venous blood of all patients above were gathered, and the level of total cholesterol (TC), triglyceride (TG), high density lipoprotein(HDL), low density lipoprotein(LDL), oxidized low density lipoproteins(ox-LDL), fibrinogen (Fg) and the inflammation factor level such as C reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)were examined and finally made analysis on the risk factors being mutually related.2. Gathered 24 patients of the CHD accompanied with periodontitis as CP treat group,along with 20 periodontitis patients of non-systematic disease as NP treat group,then carried on the periodontal non-surgical treatment. At the same time, gathered 20 patients of CHD accompanied with periodontitis as CP control group to carry on the routine medicine maintenance therapy merely. Then made observation on the change of the blood lipid and level of inflammatory factors before and after the treatment as well as the effect of the periodontal non-surgical treatment to the patients'periodontal condition and body reaction.3. 10 pieces of atherosclerotic plaques samples were collected. The bacterium's DNA were extracted from atherosclerotic plaques. Three periodontal pathogens eg. Pg, Aa, Bf were detected by PCR technique from the extracted DNA and made sequencing as well.Result:1.The prevalence rate of periodontitis was higer in CHD case group compared to control group. The analysis indicated that periodontitis possessed the marked correlation with CHD. Periodontitis and CHD not only had relations in the statistics,but also had the obvious dose responding relations. Multiple factorial logistic regression analysis displayed that periodontitis, together with other traditional risk factors such as hypertension, smoking and the family history of cardiovascular disease may be independent risk factors of CHD. The level of TC, TG, LDL, ox-LDL, Fg, hs-CRP, IL-6 and TNF-αof CHD case group were all higher than the control group, but HDL level was lower. Within CHD case group, the level of TC, TG, LDL, ox-LDL, hs-CRP, IL-6 and TNF-αof periodontitis group were all significantiy higher than those of non-periodontitis group, but HDL level was lower. And Fg level is higher,but there was not significant difference.2. The result showed that the periodontal clinical index had became better and the hs-CRP, IL-6 , TNF-α, Fg level had obviously reduced and although the blood lipid level had reduced yet did not reach the marked level after three months periodontal non-surgical treatment. Likewise, after three months, we found that serum lever of hs-CRP, IL-6, TNF-αof CP treat group had obviously differences compared to those of CP control group, and the inflammation situation of the CP treat group had greater improvement than CP control group.3.Within the 10 pieces of atherosclerotic plaques samples, Pg were detected in 20% of those samples, Aa were detected in 0% of those samples, while Bf were detected in 100% of those samples.Conclusion: Periodontitis, as one of the independent risk factors of CHD may increase the hazard rate of suffering CHD. Periodontal non-surgical treatment could control the inflammation, improve the periodontal condition, and so as to cut down the risk of suffering CHD. The DNA of periodontal pathogens was detected out from atherosclerotic plaques, which means that periodontal pathogens could have significant effect on the occurrence and development of CHD.