母亲唾液中2种牙周致病菌对胎儿的影响

目的检测早产低体重儿（pretermlowbirthweight，PLBW）与正常体重儿（normalbirthweight，NBW）母亲的牙周临床状况及唾液中牙龈卟啉单胞菌（porphyromonasgingivalis，Pg）和直形弯曲菌（campylobacterrectus，Cr）检出率，探讨2种牙周病致病菌与PLBW发生的关系。方法选取北京四所医院产后1～1．5年的母亲99人，PLBW（试验组）母亲64人，NBW（对照组）母亲35人，收集母亲唾液样本，行全口牙周检查记录探诊深度（probingdepth，PD）、菌斑指数（plaqueindex，PLI）、出血指数（bleedingindex，BI）及临床附着丧失（clinicalattachmentloss，CAL）。用PCR检测唾液中的P岔和Cr；根据赡、Cr检出与否分为％、Cr阳性组、阴性组。结果（1）PLBW和NBW牙周临床指标及与Pg、cr水平：PLBW和NBW组CAL分别（0．06，0．62）mm（25％，75％）、（0．00，0．18）mm（25％，75％），差异有统计学意义；PLBW组心检出58人的PD2．49±2.0．37；未检出5人的PD2．03±0．54，差异有统计学意义，％检出率为92．06％；NBW组唯检出28人的PD（2．47±0．35）mm，未检出7人的PD（1．91±0．35）mm，差异有统计学意义，赡检出率为80％。PLBW与NBW的瞻检出率差异无统计学意义。PLBW组cr检出55人检出率为87．30％，检出与未检出之间4项临床指标差异均无统计学意义。NBW组D检出率为91．4％，PLBW与NBW间D检出率差异无统计学意义。（2）P譬、Cr阳性组与阴性组间临床指标及与PLBW关系：Pg阳性组86人，阴性组12人，两组4项临床指标分别为PD（2．48±0．36）mm，（1．96±0．40）mm；PLI1．71±0．46，1．37±0．38；BI（1．82，3．02）（25％，75％），（1．12，2．29）（25％，75％）；CAL（0．03，0．56）ITIm（25％，75％），（0．00，0．11）mm（25％，75％）唯阳性组新生儿体重为（2482，78±833．85）g，阴性组为（3172．50±1190．1）g，差异均有统计学意义。cr阳性88人，D阳性11人，两组CAL值分别是（0．36±0．53）mm和（0．11±0．20）mm，差异有统计学意义，PD、PI、BI及新生儿体重差异均无统计学意义。结论珞、D在两组母亲唾液检出水平均高；Pg可能与PLBW发生有关；提示有必要进行孕前预防性牙周干预治疗。

Influence of two periodontal pathogens in maternal saliva on the foetus

Objective To investigate the detection rates of two anaerobic microorganisms,Porphyromonas gingivalis(Pg) and Campylobacter rectus(Cr),in mother saliva and the relationship between the two pathogens and PLBW.Method99 retrospective cases were included from 4 hospitals in Beijing urban and suburban areas.PLBW group included 64 cases and NBW group 35 cases.Nonstimulated saliva samples were collected from all the individuals.Full mouth periodontal examinations were performed and plaque index(PLI),probing depth(PD),bleeding index(BI),clinical attachment loss(CAL) were recorded.Result CALs in PLBW and NBW groups were(0.06,0.62) mm(25%,75%) and(0.00,0.18) mm(25%,75%) respectively,which was significantly different.Pg was detected in 58 cases(92.06%) in PLBW group,with the PD of(2.49±0.37) mm while that of others’ being(2.03±0.54) mm.The difference was significant.In NBW group,Pg was detected in 28 cases(80.0%),with significant different PD between positive and negative results.There was no significant difference bwteen Pg detection rate of the two groups.Cr was detected in 55 cases(87.30%) in PLBW group and 32 cases(91.4%) in NBW group,which was not significantly different.There were significant differences between Pg positive and negative cases in terms of the 4 clinical measurements and birth weight.There was significant difference between the CALs of Cr positive and negative cases,while the differences were not obvious in PD,PI,BI and BW.Conclusion Pg and Cr have high detection rates in saliva of both PLBW and NBW groups.Maternal periodontal infection may be a risk factor for PLBW,suggesting a necessity for to prophylactic treatment before pregnancy.