慢性牙髓炎患者龈沟液IL-6、MMP-8、TIMP-1水平及其与牙髓活力的关系

Levels of IL-6, MMP-8, TIMP-1 in gingival crevicular fluid of patients with chronic pulpitis and their relationship with pulp vitality

摘要:

目的 检测慢性牙髓炎患者龈沟液白介素-6（IL-6）、基质金属蛋白酶-8（MMP-8）、基质金属蛋白酶抑制剂-1（TIMP-1）水平，并分析其与患者牙髓活力的关系。方法 选取106例慢性牙龈炎患者（观察组）和106例健康志愿者（对照组）。取龈沟液测定IL-6、MMP-8、TIMP-1水平，比较两组差异；比较观察组不同临床特征患者龈沟液IL-6、MMP-8、TIMP-1水平。牙髓活力电测仪测定牙髓活力，比较不同牙髓活力患者龈沟液IL-6、MMP-8、TIMP-1水平，Pearson法分析观察组牙髓电活力（EPT）值与龈沟液IL-6、MMP-8、TIMP-1水平的相关性。结果 观察组龈沟液IL-6、MMP-8均高于对照组［（61.28±8.11）ng/L vs.（38.15±7.04）ng/L、（33.04±6.02）ng/mL vs.（20.05±4.18）ng/mL］（P<0.05），TIMP-1水平低于对照组［（1.35±0.30）ng/mL vs.（2.04±0.41）ng/mL］（P<0.05）；观察组病程≥12个月、合并糖尿病患者龈沟液IL-6、MMP-8水平均高于病程<12个月、未合并糖尿病患者（P<0.05），TIMP-1水平均低于病程<12个月、未合并糖尿病患者（P<0.05）；中度、重度疼痛患者龈沟液IL-6、MMP-8水平均高于轻度疼痛（P<0.05），且重度疼痛均高于中度疼痛（P<0.05），而TIMP-1水平变化趋势正相反；牙髓活力下降、无活力患者龈沟液IL-6、MMP-8水平均高于活力正常（P<0.05），且牙髓无活力均高于活力下降（P<0.05），而TIMP-1水平变化趋势正相反；观察组患牙EPT与龈沟液IL-6、MMP-8水平均呈正相关（r=0.715、0.689, P<0.05），与TIMP-1水平呈负相关（r=-0.673, P<0.05）。结论 慢性牙龈炎患者龈沟液IL-6、MMP-8水平均升高，TIMP-1水平下降，且与病程、疼痛程度、合并糖尿病、牙髓活力均有关。

Abstract:

Objective To detect the levels of interleukin-6 (IL-6), matrix metalloproteinase 8 (MMP-8), and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1) in gingival crevicular fluid of patients with chronic pulpitis, and to analyze the relationships between them and pulp vitality.Methods A total of 106 patients with chronic gingivitis (observation group) and 106 healthy volunteers (control group) were selected. The levels of IL-6, MMP-8, and TIMP-1 in gingival crevicular fluid were detected and the differences were compared between the two groups. The levels of IL-6, MMP-8, and TIMP-1 in gingival crevicular fluid of patients with different clinical characteristics were compared in the observation group. The pulp vitality was measured using an electrical pulp vitality meter to compare the levels of IL-6, MMP-8, and TIMP-1 in gingival crevicular fluid of patients with different pulp vitality. Pearson method was used to analyze the correlation between the pulp electrical activity (EPT) value and the levels of IL-6, MMP-8 and TIMP-1 in gingival crevicular fluid in the observation group.Results The levels of IL-6 and MMP-8 in gingival crevicular fluid in the observation group were higher than those in the control group (61.28±8.11 ng/L vs. 38.15±7.04 ng/L, 33.04±6.02 ng/mL vs. 20.05±4.18 ng/mL) (P<0.05), and the level of TIMP-1 was lower than that in the control group (1.35±0.30 ng/mL vs. 2.04±0.41 ng/mL) (P<0.05). In the observation group, the levels of IL-6 and MMP-8 in gingival crevicular fluid of patients with disease duration ≥12 months and with diabetes were higher than those of patients with disease duration<12 months and without diabetes (P<0.05), and the levels of TIMP-1 were lower than those of patients with disease duration<12 months and without diabetes (P<0.05). The levels of IL-6 and MMP-8 in gingival crevicular fluid of patients with moderate and severe pain were higher than those of mild pain (P<0.05), and those of severe pain were higher than moderate pain (P<0.05), while the trend of TIMP-1 levels was the opposite. The levels of IL-6 and MMP-8 in gingival crevicular fluid of patients with decreased pulp vitality and no vitality were higher than those of normal vitality (P<0.05), and those of no vitality were higher than decreased pulp vitality (P<0.05), while the trend of TIMP-1 levels was the opposite. The EPT of the affected teeth in the observation group was positively correlated with the levels of IL-6 and MMP-8 in gingival crevicular fluid (r=0.715, 0.689, P<0.05), and negatively correlated with the level of TIMP-1 (r=-0.673, P<0.05).Conclusion In patients with chronic gingivitis, the level of IL-6 and MMP-8 in gingival crevicular fluid increase, and the level of TIMP-1 decreases, which are related to the course of disease, the degree of pain, diabetes and pulp vitality.