李明霞 徐玉 朱斐然 宋琳 李华 刘颖 张子路 杨秋波

[摘要] 目的 探讨唾液生物标志物牙龈卟啉单胞菌（P. gingivalis）、基质金属蛋白酶-8（MMP-8）及金属蛋白酶组织抑制剂-1（TIMP-1）水平与牙周炎的相关性。 方法 选取2020年10月至2021年1月首都医科大学附属北京口腔医院牙周科收治的牙周炎患者25例作为牙周炎组，另外同期该院牙周健康者22名作为牙周健康组。记录所有研究对象牙周临床参数，收集非刺激性唾液，实时定量PCR测定P. gingivalis水平，ELISA测定MMP-8及TIMP-1水平。比较牙周炎组和牙周健康组唾液P. gingivalis、MMP-8、TIMP-1水平及MMP-8/TIMP-1比值，分析生物标志物单独或联合应用对牙周炎的诊断效能。 结果 牙周炎组唾液P. gingivalis、MMP-8水平及MMP-8/TIMP-1比值高于牙周健康组，差异有统计学意义（P<0.05）。两组TIMP-1水平比较，差异无统计学意义（P>0.05）。唾液P. gingivalis、MMP-8水平及MMP-8/ TIMP-1比值与牙周临床参数均呈正相关。P. gingivalis和MMP-8單独对Ⅱ期及以上牙周炎的预测价值中等，MMP-8/TIMP-1比值单独、P. gingivalis联合MMP-8和P. gingivalis联合MMP-8/TIMP-1比值对Ⅱ期及以上牙周炎的预测价值均较高。 结论 唾液P. gingivalis，MMP-8，尤其是MMP-8/TIMP-1比值及其联合是检测Ⅱ期及以上牙周炎的潜在候选，唾液生物标志物的联合应用进一步提高了牙周诊断的准确性。

[关键词] 牙周炎;唾液;牙龈卟啉单胞菌;基质金属蛋白酶-8;金属蛋白酶组织抑制剂-1

[中图分类号] R781.4          [文献标识码] A          [文章编号] 1673-9701（2021）28-0013-05

Correlation between salivary Porphyromonas gingivalis， MMP-8 and TIMP-1 levels and periodontitis

LI Mingxia1   XU Yu1   ZHU Feiran1   SONG Lin2   LI Hua2   LIU Ying1   ZHANG Zilu1   YANG Qiubo1

1.Beijing Institute of Dental Research， Capital Medical University School of Stomatology， Beijing  100050， China; 2.Department of Periodontics， Beijing Stomatological Hospital， Capital Medical University， Beijing   100050， China

[Abstract] Objective To investigate the correlation between salivary biomarkers Porphyromonas gingivalis （P. gingivalis）， matrix metalloproteinase-8 （MMP-8）， and tissue inhibitor of metalloproteinase-1 （TIMP-1） levels and periodontitis. Methods A total of 25 patients with periodontitis admitted to the Department of Periodontics of Beijing Stomatological Hospital， Capital Medical University from October 2020 to January 2021 were selected as the periodontitis group. Another 22 subjects of periodontal health in the hospital during the same period were selected as the periodontally healthy group. Periodontal clinical parameters were recorded in all study subjects. Unstimulated saliva was collected. Real-time quantitative PCR was performed to determine P. gingivalis level. MMP-8 and TIMP-1 levels were measured by ELISA. The levels of P. gingivalis， MMP-8 and TIMP-1 and MMP-8/TIMP-1 ratio in saliva were compared between the periodontitis and control groups， and the diagnostic power of biomarkers for periodontitis was analyzed. Results Salivary P. gingivalis， MMP-8 levels， and MMP-8/TIMP-1 ratio in the periodontitis group were higher than those in the periodontally healthy group， and the differences were statistically significant （P<0.05）. There was no significant difference in TIMP-1 level between the two groups （P>0.05）. Salivary P. gingivalis， MMP-8 levels， and MMP-8/TIMP-1 ratio were positively correlated with periodontal clinical parameters. The predictive value of P. gingivalis and MMP-8 alone for stage Ⅱ and above periodontitis was moderate. The predictive value of MMP-8/TIMP-1 ratio alone， P. gingivalis combined with MMP-8， and P. gingivalis combined with MMP-8/TIMP-1 ratio for stage Ⅱ and above periodontitis was high. Conclusion Salivary P. gingivalis， MMP-8， especially MMP-8/TIMP-1 ratio， and their combinations are potential candidates for detecting stage Ⅱ and above periodontitis， and the combination of salivary biomarkers further improves the accuracy of periodontal diagnosis.

[Key words] Periodontitis; Saliva; Porphyromonas gingivalis; Matrix metalloproteinase-8; Tissue inhibitor of metalloproteinase-1

牙周炎是发生在牙齿支持组织（牙周组织）的疾病，如果不及时诊断和治疗，会导致牙周软组织和硬组织不可逆破坏，最终导致牙齿脱落[1]。牙周炎不仅是导致成年人牙齿丧失的主要原因，还与广泛的系统性疾病有关[2]。目前牙周炎的诊断主要依靠牙周检查，而传统牙周检查的准确性依赖于检查者的临床经验，主观性较强，通常需要牙周专科医师完成。……