Observation On The Curative Effect Of Periodontal Therapy On Chronic Periodontitis With Coronary Heart Disease

Objective: For the purpose of the study,40 chronic periodontitis with coronary heart disease cases were recruited.The objective of this research was to explore fluctuations in the concentrations of Interleukin-17(IL-17),high sensitive C-reactive protein(hs-CRP)in gingival crevicular fluid and serum,blood lipid levels and changes in ECG which were important for evaluating the effect of periodontal therapy on chronic periodontitis with coronary heart disease and to search the sensitivity and specificity inflammatory factors in gingival crevicular fluid and peripheral blood.It will provide a convenient and efficient method for assessing early chronic periodontitis and the coronary artery disease.Methods:1 Experimental subjects:According to the American Journal of Periodontology Symposium proposed chronic gastritis diagnostic criteria(1999),and the International Association of Cardiology and World Health Organization Clinical Standardization Joint Professional Group presented the diagnostic criteria for coronary heart disease(1979),40 chronic periodontitis with coronary heart disease cases were collected from the Department of heart of Hebei Medical University Second Hospital and the Department of preventive medicine of Hospital of Stomatology Hebei Medical University.All patients aged from 47 to 66 years old,including 29 males and 11 females.2 Experimental groups:All patients were randomly divided into treatment group(n=20)and control group(n=20).Group treatment: Intracardiac routine treatment and periodontal therapy.Group control: Intracardiac routine treatment and oral hygiene mission.3 Experimental methods:3.1 Detect the situation of periodontal tissue:check and record the situation of periodontal tissue when all patients collected at the beginning(baseline)and 4weeks after treatment,including probing depth(PD),attachment level(AL),bleeding on probing(BOP).3.2 Detect the peripheral venous blood: collect every patient 15 mL peripheral venous blood on an empty stomach in the morning at baseline and 4 weeks later.Blood and blood lipids were estimated by the automated hematology analyzer and the blood biochemical automatic analyzer.Serum IL-17 and hs-CRP levels were estimated by enzyme linked immunesorbant assay(ELISA).3.3 Detect the GCF: collect every patient GCF at the baseline,4 weeks after treatment.Highest scored site per quarter in the oral cavity was selected to collect GCF sample for every patient.Six points were collected for per teeth which to be tested.3.4 Detect ECG: detect every patient ECG at baseline,4 weeks after treatment in the Department of functional of Hebei Hospital of Chinese Medical.3.5 Evaluate the symptom of the coronary heart disease: The Seattle Angina Questionnaire(SAQ)for every patient was scored at baseline,4 weeks after treatment in the Department of heart of Hebei Medical University Second Hospital.Results:1.At baseline,there was no significant difference in PD,AL,BOP,GCF and serum IL-17,hs-CRP levels,WBC,blood lipids,ECG and SAQ between the two groups(P> 0.05).2.Four weeks later,the levels of PD,AL,BOP,the concentrations of GCF and serum IL-17,hs-CRP,triglycerides(TG)and high-density lipoprotein(HDL),very low density lipoprotein(v LDL)were significantly different between the treatment group and the control group(P<0.05).There was no significant difference between the two groups in WBC,total cholesterol(TC),low density lipoprotein(LDL),electrocardiogram(ECG) and SAQ(P> 0.05).3.Four weeks later,the levels of PD,AL,BOP,GCF and serum IL-17,hs-CRP,WBC,TG and v LDL in the treatment group were significantly lower than those in the baseline of the treatment group(P<0.05).The concentrations of HDL and SAQ in the treatment group were significantly higher than those in the baseline of the treatment group(P<0.05).TC,LDL,ECG differences were not significant(P> 0.05).4.In control group,there was no significant difference in the levels of PD,AL,BOP,GCF and serum IL-17,hs-CRP,WBC,TC,LDL between baseline and 4 weeks later(P>0.05).The levels of TG and v LDL were significantly lower than baseline(P<0.05).The concentrations of HDL and SAQ were significantly higher than baseline(P<0.05).Conclusions:1.Periodontal treatment can significantly improve periodontal inflammation and the levels of hs-CRP and IL-17 in gingival crevicular fluid in a certain period of time,effectively controlling infection.2.Periodontal basic therapy can significantly improve the levels of TG,HDL,and v LDL in patients with coronary heart disease,and it has a positive effect on the treatment of patients with coronary heart disease.This conclusion helps to provide a reasonable comprehensive treatment plan for patients with coronary heart disease.3.IL-17,hs-CRP and lipids play important roles in the development of the chronic periodontitis and coronary atery disease.