Diabetes Care:口腔疾病治疗对预防血管疾病的影响

2019-12-29 xing.T MedSci原创

由此可见,为T2D和牙周炎患者提供非手术性牙周治疗有望通过改善血糖控制显著减少牙齿脱落和与T2D相关的微血管疾病。鼓励患有T2D和口腔健康状况不佳的患者接受牙周治疗将改善健康状况,并且仍然可以节省成本或具有成本效益。

先前的随机试验发现,治疗牙周炎可改善2型糖尿病(T2D)患者的血糖控制,从而降低患T2D相关的微血管疾病和心血管疾病(CVD)风险。在美国,一些付费机构已开始为患有慢性疾病(例如糖尿病)的个体提供非手术牙周治疗。近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员试图确定在T2D患者中扩大牙周治疗覆盖面的成本效益。

研究人员使用口腔健康状况、T2D、T2D相关微血管疾病和美国人群CVD的随机微仿真模型进行了成本效益分析,以估算生命周期成本和健康收益。模型参数来自全国代表性的国家健康与营养调查(NHANES)(2009-2014年)以及T2D患者的牙周治疗随机试验。

预计在T2D和牙周炎患者中扩大牙周治疗覆盖面可避免34.1%(95%CI为-39.9至-26.5)的牙齿脱落,可避免20.5%(95%CI -31.2至-9.1)的微血管疾病,分别可避免20.5% (95%CI为−31.2至−9.1)、17.7% (95%CI为−32.7至−4.7),和19.2%(95%CI为-18.4至-3.5)的肾病、神经病和视网膜病。从医疗保健的角度来看,向目标人群提供牙周治疗将节省成本,总净节省额为5904美元(95%CI为-6,039至-5,769),估计人均获得0.6 QALYs(95%CI为0.5-0.6) 。

由此可见,为T2D和牙周炎患者提供非手术性牙周治疗有望通过改善血糖控制显著减少牙齿脱落和与T2D相关的微血管疾病。鼓励患有T2D和口腔健康状况不佳的患者接受牙周治疗将改善健康状况,并且仍然可以节省成本或具有成本效益。

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