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J Endod：抗肿瘤坏死因子对白鼬根尖周炎愈合的影响

2017-10-09 lishiting MedSci原创

anti-TNFα根尖周炎
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由于临床越来越多的使用抗肿瘤坏死因子(anti-TNFα)生物制剂，并且它们可以影响和干预免疫-炎症反应。为此，这篇研究评估阿达木单抗(anti-TNFα)是否会对白鼬根尖周炎(AP)愈合以及愈合时间产生影响。

由于临床越来越多的使用抗肿瘤坏死因子(anti-TNFα)生物制剂，并且它们可以影响和干预免疫-炎症反应。为此，这篇研究评估阿达木单抗(anti-TNFα)是否会对白鼬根尖周炎(AP)愈合以及愈合时间产生影响。

研究选取12只雄性白鼬作为实验对象，通过CBCT在不同时间段监测实验动物根尖愈合情况：在健康时(T0)； AP确诊时(T1)； 根管治疗(RCT)后30天(T2)， 60天(T3)和90天(T4)。所有动物在其尖牙诱导AP形成；3只白鼬(12 teeth)用作阳性对照并进行组织学评估；9只白鼬按照治疗方法的不同随机分为3个组且每组12个牙齿：全身性： 常规RCT和全身性anti-TNFα； 局部： RCT和根管充填前根尖周给予anti-TNFα药物； 仅常规RCT (对照)。由2名资深的放射线学者分别对CBCT影像进行分析并且在彼此不知情的情况下对AP进行鉴定和定量。通过Rank-based协方差分析对损伤范围进行统计学评估。

结果显示，AP在所有牙齿上诱导成功。RCT后，3个组所有AP病变的区域范围均有显著减小。相关样本的特殊配对比较(通过每组ranks的Friedman's 2-way方差分析)结果显示，所有3组随着愈合时间的延长损伤范围均呈减弱的趋势，最明显的是局部组(局部施加阿达木单抗)。而在各组间未见显著性差异。

结论：在此次的动物模型中，全身性和局部施以anti-TNFα并没有阻碍AP的愈合，并且可以预期anti-TNFα可能会加快愈合反应速度。另外，这项发现有助于日后进行的大样本量研究。

原始出处：

Cotti E， Abramovitch K， et al. The Influence of Adalimumab on the Healing of Apical Periodontitis in Ferrets. J Endod. 2017 Sep 26. pii： S0099-2399(17)30772-0. doi： 10.1016/j.joen.2017.06.019.

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    2017-10-11 millore

    #坏死#

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    2017-10-11 zhangbaojun

    #根尖周炎#

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    2017-10-11 ms7524819409032184

    #肿瘤坏死因子#

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    2017-10-11 zblhy

    #抗肿瘤坏死因子#

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    2017-10-11 zblhy

    #抗肿瘤坏死因子#

    0