J Clin Periodontol:牙龈疾病或可增加慢性肾病患者的死亡率(附评论)

2016-02-19 MedSci MedSci原创

J Clin Periodontol:牙龈疾病或可增加慢性肾病患者的死亡率据发表于Journal of Clinical Periodontology的一项新的研究表明,同时患有严重牙龈病或牙周炎的慢性肾病患者的死亡发生风险较牙龈健康的慢性肾病患者高。该研究为口腔健康与全身慢性疾病之间的关联提供了进一步的证据。资深作者Iain Chapple说道,我们应意识到口腔健康并不仅仅是牙齿的健康,口腔是身

MedSci编者按:

细心的医生朋友可能会发现,在MedSci医学里发表过不少有关口腔,牙周,牙龈疾病与全身其它系统性疾病的关系(心血管,消化,肾脏,呼吸等)。这一点希望能引起大家重视。至少有以下几个原因。(1)人类还有几个神奇的地方,一个是肠道微生物,被称为第二大脑,与全身很多系统性疾病都有关系。而除肠道外,口腔微生物实际上可以称为第三大脑,也与很多疾病有关。在中医中讲“上火”,表现为口臭,口干。我们一般认为没有科学道理。其实,很有可能是因为其它系统性疾病影响到口腔微生物群落发生改变,这些微生物代谢发生变化,从而产生异味或对口腔粘膜上皮细胞产生刺激感觉。完全值得深入研究。(2)口腔的变化,可能是系统性疾病的外界表现。系统性疾病,如一些急慢性疾病,不仅仅是病灶局部有改变,而应该是全身性变化,只是人体大部分部位可能不敏感而已。但相对来说,口腔属于相对敏感部位,容易感受到疾病的一些变化,这也是值得研究的。(3)口腔本身与慢性疾病的关系。现在认为很多慢性疾病都与微生物感染,或微炎症有关。如粥样斑块,可能与支原体感染,HCMV病毒感染等有关,目前这方面证据已不少。牙周,牙龈上很多微生物,有可能是一些慢性疾病的源头。如果口腔微生态失调,这些微生物就有可能侵入人体。这被认为是口腔疾病与全身性疾病关联的重要原因之一。

因此,MedSci小编希望大家如果想做一些科研,在观察患者的基本资料同时,可以顺手记录一下口腔的变化,例如是否有牙周炎,牙龈疾病,再分析这些疾病与你观察的其它系统疾病之间的关系,有可能得出令人吃惊的结论!

如果大家要了解更多信息,请下载APP,并在APP中搜索


据发表于Journal of Clinical Periodontology的一项新的研究表明,同时患有严重牙龈病或牙周炎的慢性肾病患者的死亡发生风险较牙龈健康的慢性肾病患者高。

该研究为口腔健康与全身慢性疾病之间的关联提供了进一步的证据。资深作者Iain Chapple说道,我们应意识到口腔健康并不仅仅是牙齿的健康,口腔是身体的入口,而不是一个独立的器官,它是细菌从牙龈进入血液的通道。

Iain Chapple教授及其同事供分析了13734名参与第三次全国健康和营养调查(NHANES III)的参与者的数据。结果发现861名(6%)的参与者患有慢性肾病,对其随访14.3年。

然后研究人员评估了牙周炎与慢性肾病患者死亡率之间的关系,并将其与慢性肾病患者死亡率与其他危险因素(如糖尿病)之间的关系进行了对比。

校正其他潜在的影响因素后,研究人员发现,随访10年后,未伴有牙周炎的慢性肾病患者的死亡率为32%,而伴有牙周炎的慢性肾病患者的死亡率为41%。这与糖尿病的影响效果相当。研究人员发现,未伴有慢性牙周炎的慢性肾病患者的10年死亡率在非糖尿病者中为32%,而在糖尿病者中为43%。

牙周炎是一种严重的慢性非传染性的牙龈感染性疾病,累及牙齿的软硬支持组织,是人类第六常见疾病,全世界发病率约为11.2%。

研究人员注意到,肾脏疾病进而其他非传染性疾病正变得越来越普遍,部分是由于世界人口老龄化的影响,生活方式变得越来越不活跃,饮食也越来越精细。

这些疾病的增加也增加了全球疾病的负担以及医疗护理的费用:有证据表明92%的老年人至少患有一种慢性疾病。

Chapple教授解释道,很多牙龈病患者并未意识到自己患有牙龈病,或许仅是刷牙时出一点血。但是,如果他们并未因此而做检查,那么便有可能无意间增加身体其他部分发生疾病的风险。

目前,研究人员正密切关注牙龈疾病与肾病之间的关系,以观察二者之间的联系是否仅是一个巧合,或牙龈疾病是否可导致肾病的发生。如果二者存在因果关系,那么研究人员希望解决这个问题:治疗牙龈疾病或改善口腔卫生是否可改善慢性肾病患者的预后。

最后,Chapple教授总结道:

“牙龈疾病的诊断或可为其他疾病的早期检测提供了一个机会,通过这个机会牙科专业人员可采取一种有针对性的,以风险为基础的方法来筛查其他的慢性疾病。“

原始出处:.

Praveen Sharma et al., Association between Periodontitis and mortality in stages 3-5 Chronic Kidney Disease: NHANES III and linked mortality study, Journal of Clinical Periodontology, doi:10.1111/jcpe.12502, published online 31 December 2015.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=2025792, encodeId=8ca02025e9237, content=<a href='/topic/show?id=a91d82583bf' target=_blank style='color:#2F92EE;'>#肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82583, encryptionId=a91d82583bf, topicName=肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db5b227, createdName=gostraight, createdTime=Thu Nov 17 08:12:00 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124711, encodeId=d8fe124e1180, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124431, encodeId=9b3112443126, content=赞一个!好文章,认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:16:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726038, encodeId=639f1e2603889, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sun Mar 27 11:12:00 CST 2016, time=2016-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055937, encodeId=f911205593e08, content=<a href='/topic/show?id=d088536467a' target=_blank style='color:#2F92EE;'>#慢性肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53646, encryptionId=d088536467a, topicName=慢性肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Jun 23 18:12:00 CST 2016, time=2016-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65083, encodeId=42b365083f2, content=以后的重视了, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160221/IMG56C969E52B9822818.jpg, createdBy=1d3d1689791, createdName=1de55938m29(暂无匿称), createdTime=Sun Feb 21 16:18:00 CST 2016, time=2016-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65009, encodeId=79c56500971, content=重视牙周, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Sun Feb 21 00:46:00 CST 2016, time=2016-02-21, status=1, ipAttribution=)]
    2016-09-13 1e10c84am36(暂无匿称)

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    0

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    2016-09-13 ylzr123

    赞一个!好文章,认真学习了。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2025792, encodeId=8ca02025e9237, content=<a href='/topic/show?id=a91d82583bf' target=_blank style='color:#2F92EE;'>#肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82583, encryptionId=a91d82583bf, topicName=肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db5b227, createdName=gostraight, createdTime=Thu Nov 17 08:12:00 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124711, encodeId=d8fe124e1180, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124431, encodeId=9b3112443126, content=赞一个!好文章,认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:16:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726038, encodeId=639f1e2603889, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sun Mar 27 11:12:00 CST 2016, time=2016-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055937, encodeId=f911205593e08, content=<a href='/topic/show?id=d088536467a' target=_blank style='color:#2F92EE;'>#慢性肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53646, encryptionId=d088536467a, topicName=慢性肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Jun 23 18:12:00 CST 2016, time=2016-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65083, encodeId=42b365083f2, content=以后的重视了, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160221/IMG56C969E52B9822818.jpg, createdBy=1d3d1689791, createdName=1de55938m29(暂无匿称), createdTime=Sun Feb 21 16:18:00 CST 2016, time=2016-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65009, encodeId=79c56500971, content=重视牙周, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Sun Feb 21 00:46:00 CST 2016, time=2016-02-21, status=1, ipAttribution=)]
    2016-03-27 feather89
  5. [GetPortalCommentsPageByObjectIdResponse(id=2025792, encodeId=8ca02025e9237, content=<a href='/topic/show?id=a91d82583bf' target=_blank style='color:#2F92EE;'>#肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82583, encryptionId=a91d82583bf, topicName=肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db5b227, createdName=gostraight, createdTime=Thu Nov 17 08:12:00 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124711, encodeId=d8fe124e1180, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124431, encodeId=9b3112443126, content=赞一个!好文章,认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:16:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726038, encodeId=639f1e2603889, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sun Mar 27 11:12:00 CST 2016, time=2016-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055937, encodeId=f911205593e08, content=<a href='/topic/show?id=d088536467a' target=_blank style='color:#2F92EE;'>#慢性肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53646, encryptionId=d088536467a, topicName=慢性肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Jun 23 18:12:00 CST 2016, time=2016-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65083, encodeId=42b365083f2, content=以后的重视了, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160221/IMG56C969E52B9822818.jpg, createdBy=1d3d1689791, createdName=1de55938m29(暂无匿称), createdTime=Sun Feb 21 16:18:00 CST 2016, time=2016-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65009, encodeId=79c56500971, content=重视牙周, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Sun Feb 21 00:46:00 CST 2016, time=2016-02-21, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2025792, encodeId=8ca02025e9237, content=<a href='/topic/show?id=a91d82583bf' target=_blank style='color:#2F92EE;'>#肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82583, encryptionId=a91d82583bf, topicName=肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=db5b227, createdName=gostraight, createdTime=Thu Nov 17 08:12:00 CST 2016, time=2016-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124711, encodeId=d8fe124e1180, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124431, encodeId=9b3112443126, content=赞一个!好文章,认真学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:16:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726038, encodeId=639f1e2603889, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Sun Mar 27 11:12:00 CST 2016, time=2016-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2055937, encodeId=f911205593e08, content=<a href='/topic/show?id=d088536467a' target=_blank style='color:#2F92EE;'>#慢性肾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53646, encryptionId=d088536467a, topicName=慢性肾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=568152, createdName=snowpeakxu, createdTime=Thu Jun 23 18:12:00 CST 2016, time=2016-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65083, encodeId=42b365083f2, content=以后的重视了, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160221/IMG56C969E52B9822818.jpg, createdBy=1d3d1689791, createdName=1de55938m29(暂无匿称), createdTime=Sun Feb 21 16:18:00 CST 2016, time=2016-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=65009, encodeId=79c56500971, content=重视牙周, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Sun Feb 21 00:46:00 CST 2016, time=2016-02-21, status=1, ipAttribution=)]
    2016-02-21 1de55938m29(暂无匿称)

    以后的重视了

    0

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    2016-02-21 xiaotaiyang1

    重视牙周

    0

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