The Change Of IL-6 And TNF-α Levels Of Unstimulated Saliva In Patients With OSAHS And OSAHS Associated Periodontitis

Objective:Periodontal had become a very common oral disease, it was caused by plaque of periodontal tissue inflammation.Obstructive sleep apnea-hypopnea syndrome(OSAHS)was characterized by that the normal structure of breathing during sleep was interrupted again and again during the night sleep, and caused the whole body each system could be damaged.Studies have showed that inflammation of periodontal disease and obstructive sleep apnea syndrome was in a common inflammatory pathways, May be both of the OSAHS and periodontitis synergistic effect to change the host’s inflammatory response.The experiment research detection interleukin-6(IL-6) and Tumor necrosis factor alpha(TNF-α)the level in saliva,of obstructive sleep apnea-hypopnea syndrom(OSAHS),and with periodontitis patients, analysis of the relationship between OSAHS and periodontitis.The purpose is to investigate the relationship between OSAHS and periodontitis, and pathogenic mechanism of OSAHS and how it work.By this,it can provide the clinical theory basis to prevention and control.Methods:Randomly choose 75 cases of OSAHS patients from the hospital of Shan Xi medical university,all of the OSAHS patients guided sleep polysomnography(PSG) monitoring and diagnosis.They were judging by the Chinese medical association, sleep respiratory disease diagnosis,40 cases in which group of OSAHS with periodontitis patients(male15,female25), no complications patients with OSAHS 35(male15,female20).No complications periodontitis group 30 cases(male17, female 13),25 cases of normal healthy controls(male12, female13)By asking the history and PSG to check at the OSAHS,periodontitis diagnosis standard: according to the international seminar periodontal disease classification criteria laid out in 1999.Comparison between the four groups of gender, age,body mass index(BMI), there was no significant difference(p > 0.05).All selected objects except 1. HTN, DIAB 2.Hyperthyroidism,3. Patients with acute or chronic salivary gland inflammation,Sialolithiasis,Sjogren syndrome,and other dry mouth syndrome 4. Used of the sympathetic nerve inhibition medicine, etc. 5. Accompanied by other oral mucosal disease, such as oral ulcer 6. After head and neck radiotherapy antibiotics7. antibiotic8.Pregnancy and lactation 9. Smoking 10. Obesity, etc.Patients with OSAHS wear PSG to sleep,(time> 8 h), Morrow morning when they wake up, drinking water, but asked for an empty stomach.Patients remain seated, waiting for 10 to 15 min, when the saliva accumulated in the mouth,collected 1-2ml.The laboratory centrifuge, immediately take the supernatant, cryopreserved, ELISA test.At the same time record clinical periodontal probing clinical outcome and monitor the indicators about sleep.Statistical analysis of pure OSAHS periodontitis with OSAHS sleep the two groups monitoring indicators;And between the four groups of IL-6 and TNF alpha level, clinical periodontal diagnosis results,the final clinical periodontal attachment loss in patients with OSAHS periodontitis group change, and this group of IL-6 in saliva, content of TNF alpha level, linear correlation analysis.Results:Clinical periodontal index, comparing four groups that OSAHS+periodontitis group of PD and AL is most serious, and OSAHS periodontitis, periodontitis group, OSAHS group of PD, AL were higher than in normal control group, the difference was statistically significant(P < 0.05).OSAHS group, PD, AL below OSAHS periodontitis and periodontitis group was statistically significant(P<0.05); The four groups of saliva,between groups all have obvious difference, statistical results significance(P < 0.05);The normal control group was the lowest.OSAHS periodontitis group, level of IL-6,TNF-α in turn, is more than simple periodontitis group, pure OSAHS group, the difference was statistically significant(P < 0.05);The OSAHS+periodontitis group of saliva IL- 6, TNFalpha, and clinical periodontal clinical results are linear correlation analysis, the results showed that saliva IL- 6,TNF-alphaf and PD, AL were positively correlated(r = 0.628, r =0.653)Conclusions:We successfully use the whole unstimulated saliva to detected IL-6, TNF-α that means the saliva can be a new measurements for the periodontits;Except the sex,age, BMI and system diease,the whole unstimulated saliva to IL-6, TNF-α concentrations in patients with OSAHS was higher than control subjects. That means OSAHS was a The inflammatory response itself;The whole unstimulated saliva to IL-6, TNF-α concentrations in patients with OSAHS+periodontits was higher than periodontits,means OSAHS can make the periodonits more seriously;The linear correlations between the IL-6、TNF-αand PD and AL in patients with OSAHS+periodontits. We conclude that OSAHS was an independent factor to periodontits. The inflammatory degree of OSAHS might predict the dangerous of periodontits. The saliva IL-6 and TNF-α might as important predictors to inspect state of OSAHS, to filtrate those dangerous patients, to supervise therapy and to estimate prognosis.