牙周炎与类风湿性关节炎发病有关

摘要 目的：本次横断面研究旨在探究牙周炎的严重程度和类风湿性关节炎的临床表现之间的关联。

方法：本研究共纳入了264名类风湿性关节炎患者和88名匹配了年龄和性别对照人群，并对所有研究对象进行牙科检查。此外，还要评估类风湿性关节炎患者的临床表现，包括疾病活动性和抗环瓜多肽抗体。

结果：与对照人群相比，类风湿性关节炎患者的中度或重度牙周炎的患病率较高（63.6% vs 34.1%, p < 0.001）。在牙周炎症标志物中，发现探诊时出血与疾病活动评分28（r="0.128," p="0.041）、类风湿性关节炎病程（r" ="0.211," p="0.001）、红细胞沉降率（ESR;" r="0.141," p="0.023）、抗环瓜多肽抗体（r" ="0.183," p="0.009）和抗环瓜多肽抗体α烯醇化酶肽-1抗体（r" ="0.225," p < 0.001)相关。牙龈指数与类风湿性关节炎的病程、esr、抗环瓜氨酸肽抗体和抗环瓜氨酸肽抗体α烯醇化酶肽-1抗体相关。与没有共同抗原表位的患者相比，存在人类白细胞抗原（hla）-drb1共同表位的类风湿性关节炎患者，代表牙周结构损伤程度的牙周探诊深度和囊袋附着水平较低（p="0.005" and p="0.006）。

结论：与对照组人群相比，类风湿性关节患者的中度或重度牙周炎患病率较高。牙周组织炎症与类风湿性关节炎的病程、ESR及抗环瓜氨酸肽抗体有关。存在HLA-DRB1共同抗原表位的类风湿性关节患者的牙周组织结构破坏较小。

附原文:AbstractBACKGROUND/AIMS:A cross-sectional study was undertaken to investigate the association between severity of periodontitis and clinical manifestation of rheumatoid arthritis (RA).METHODS:Two hundred sixty-four RA patients and 88 age- and sex-matched controls underwent dental exam. Additionally, clinical manifestations including disease activity and anti-citrullinated protein antibodies were evaluated in RA patients.RESULTS:The prevalence of moderate or severe periodontitis was higher in RA patients compared to controls (63.6% vs 34.1%, p < 0.001). in markers of periodontal inflammation, bleeding on probing was correlated with disease activity score 28 (r="0.128," p="0.041)," ra disease duration (r="0.211," p="0.001)," erythrocyte sedimentation rate (esr; r="0.141," p="0.023)," anti-cyclic citrullinated peptide antibody (r="0.183," p="0.009)," and anti-citrullinated α-enolase peptide-1 antibody (r="0.143," p="0.025)." gingival index was correlated with ra duration (r="0.262," p < 0.001), esr (r="0.162," p="0.009)," anti-cyclic citrullinated peptide antibody (r="0.203," p="0.004)" and anti-citrullinated α-enolase peptide-1 antibody (r="0.225," p < 0.001). periodontal structural damage represented by probing pocket depth and clinical attachment level were less in ra patients with human leukocyte antigen (hla)-drb1 shared epitope compared than those without shared epitope (p="0.005" and p="0.006," respectively).conclusions:the prevalence of moderate or severe periodontitis was increased in ra patients compared to controls. periodontal inflammation was correlated with ra disease duration, esr, and anti-citrullinated protein antibodies. periodontal structural damage was less in ra patients with hla-drb1 shared epitope.

Choi IA¹, Kim JH², Kim YM², Lee JY³, Kim KH^2,4, Lee EY¹, Lee EB¹, Lee YM^2,4, Song YW^1,3.Periodontitis is associated with rheumatoid arthritis: a study with longstanding rheumatoid arthritis patients inKorea. Korean J Intern Med. 2016 Mar 25. doi: 10.3904/kjim.2015.202. [Epub ahead of print]