JAHA:好好刷牙!中风患者的大脑里,竟然发现了口腔细菌的痕迹

2019-05-29 佚名 医学新视点

研究人员在84%的血栓样本中检测到了细菌的DNA,其中绝大部分患者的血栓中含有常见于口腔的链球菌DNA。

研究人员在84%的血栓样本中检测到了细菌的DNA,其中绝大部分患者的血栓中含有常见于口腔的链球菌DNA。

口腔健康是全身健康重要组成部分。近年来,有不少研究反映了牙周病和血管疾病的关联。人们通常认为,这可能是因为感染引起的炎症具有全身效应。然而,也有研究提出,背后的机制也许更为复杂。

最近,来自芬兰坦佩雷大学(Tampere University)的研究团队在中风患者的大脑血栓中发现了常见的口腔细菌的迹象!这意味着,除了炎症,细菌可能还参与了血栓的形成。这项研究也发表在美国心脏协会的官方期刊Journal of the American Heart Association。

该研究团队对细菌感染血管疾病的关联已经研究了10多年。此前,他们已经在心梗的血栓样本中发现了口腔细菌——甲型溶血性链球菌的DNA。另外有研究发现,脑动脉瘤和腿部血栓中也有同样的细菌痕迹。

这种细菌已知会引起感染性心内膜炎,并与血栓形成有关。但在大脑动脉血栓方面,口腔细菌是否起了作用还是未知。随着支架植入、抽吸取栓等脑血运重建技术的发展,研究人员现在也有机会对脑血栓展开研究。

这项新研究纳入了2013年-2017年期间在芬兰坦佩雷大学医院接受机械取栓治疗的75名缺血性卒中(中风)患者,对抽吸出的血栓中的细菌进行了测定。

研究人员在84%(63人)的血栓样本中检测到了细菌的DNA,其中绝大部分患者(59人)的血栓中含有常见于口腔的链球菌DNA。更惊人的一个数字是,和这些患者自身的血液样本相比,血栓中所有细菌DNA的平均含量几乎是其8倍,血栓中链球菌DNA的平均含量也是对照血液样本的5倍多。

研究第一作者Olli Patrakka博士指出,这是“第一项显示缺血性卒中患者普遍存在这种细菌感染的研究,在动脉粥样硬化相关严重并发症,如血栓的形成中,口腔细菌可能发挥了作用。”

关于口腔健康和心血管疾病的猜测,美国心脏协会曾在2012年召集专家小组开展讨论。当时的科学声明显示,还缺乏足够的证据表明由细菌引起的牙龈疾病是导致心脏病的原因,或者治疗牙龈疾病有助于预防心脏病。

虽然这项新研究确实揭示了大脑中的口腔细菌痕迹,但业内专家的态度仍然比较谨慎。2012年参与科学声明的卡罗莱纳医疗中心口腔医学系Peter B. Lockhart教授认为,无论个人是否健康,或是否患有牙周疾病,口腔细菌进入血液的情况并不少见。曾经,血液被认为是无菌的,“但现在我们已经知道细菌存在于全身,包括血液中,在血栓中找到细菌痕迹不一定意味着它们在疾病过程中发挥作用。”

不过,研究团队相信,“未来的研究将强化这种观点:口腔护理对人们的健康影响比以前认为的更重要。”Patrakka博士也表示,定期进行牙科检查可能有助于降低患心脏疾病的风险。

参考文献:

Olli Patrakka, et al. (2019). Oral Bacterial Signatures in Cerebral Thrombi of Patients With Acute Ischemic Stroke Treated With Thrombectomy. Journal of the American Heart Association.

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    2019-05-31 zhaohui6731
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    2019-05-29 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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