| Objective:To investigate the correlation that was among periodontal disease, risk of ischemic stroke and its possible mechanism.Methods:From April2012to March2013, in Liaoning province people’s Hospital department of internal medicine nerve,98cases of hospitalized patients with ischemic stroke within72hours of onset were collected as the object of study (cases), and randomly selected over the same period because of dizziness, but no history of stroke patients of82cases as control group recently. Collect the clinical data of patients in general that was admitted to the hospital within3days of the determination of serum high sensitivity C reactive protein, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein levels in the hospital a week expert carotid artery ultrasonography. According to the severity of the periodontal lesions, they could be divided into no periodontal disease, mild periodontal disease, periodontal disease, moderate to severe periodontal disease of all the subjects on hospitalization within one week of oral periodontal. Package for statistical analysis of the data using SPSS16.0statistical software, t test and chi-square test were used to count with measurement data. The relationship between periodontal disease and risk of ischemic stroke was analyzed by logistic regression model of step-back technique with multiple factors. At the same time, we also explored the relationship between the case group with high sensitivity C reactive protein levels and periodontal disease.Results:Compared with the case group and control group, no significant difference was found between the two groups in age, sex, body mass index, drinking history ratio (P>0.01); stroke risk in the case group factors including hypertension, diabetes, dyslipidemia, smoking, prevalence rate of carotid atherosclerosis was significantly higher than that of the control group (P<0.01). The proportion of patients with periodontal disease were significantly higher than that of the control group (71.4%VS41.5%, P<0.01). The proportion of patients with severe periodontal diseases was significantly higher than that of the control group (60%VS23.5%,P<0.01). Multivariate logistic regression analysis showed that the risk factors for ischemic stroke such as hypertension, smoking, diabetes, atherosclerosis, hs-CRP level, periodontal disease were also associated with the onset of the risk of ischemic stroke, and independent risk factors, the risk factors associated with diabetes (OR7.37,95%CI1.20～25.49, P<0.01), followed by smoking (OR6.54,95%CI1.75～24.40, P<0.01), hypertension (OR6.34, most95%C12.69～20.02, P<0.01), periodontal disease (OR5.80,95%CI2.26-14.87, P<0.01), carotid atherosclerosis (OR5.24,95%CI2.17～17.96, P<0.01), high sensitive C reactive protein level (OR3.73,95%CI1.24-9.40, P<0.01). Serum hs-CRP level in the patients was significantly higher than the control group [(3.30±2.85mg/L) VS (1.70±1.26mg/L),(P<0.01)]; severe periodontal disease patients the level of hs-CRP in the case group was significantly higher than that in mild to moderate periodontal disease patients [(4.40±3.40mg/L) VS (2.95±3.02mg/L),(P<0.01)]. Multivariate logistic regression analysis, results demonstrated that smoking, high sensitive C reactive protein level were associated with periodontal disease (P<0.01).Conclusion:1. As a result of the interaction of various factors, risk factors for ischemic stroke were not determined by single factors; in addition to the traditional risk factors, relative risk of periodontal disease and ischemic stroke might be an independent risk factor for ischemic stroke; with the increasing severity of periodontal disease, it also increased in patients with ischemic stroke risk.2. High sensitivity C reactive protein level increased significantly in ischemic stroke which was complicated with periodontal disease patients. It suggested that periodontal disease could promote the process of atherosclerosis through inflammatory mechanisms, so that the risk of ischemic stroke. |
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