目的 探讨牙种植体周围黏膜炎龈沟液可溶性人基质裂解素(sST2)、成纤维细胞生长因子21(FGF21)水平变化的临床意义。方法 选取2022-06至2024-06就诊于解放军总医院第三医学中心牙种植体周围黏膜炎患者为观察组,共97例,另选取同期97例天然牙牙龈健康志愿者为天然牙对照组,97例种植体周围牙龈健康者为种植体对照组。采用酶联免疫吸附(ELISA)法对3组人员龈沟液中sST2、FGF21表达水平检测;多因素logistic回归分析患者预后不良影响因素;绘制受试者工作特征(ROC)曲线评估sST2、FGF21水平对患者预后不良预测能力。结果 与天然牙对照组和种植体对照组相比,观察组患者龈沟液sST2、FGF21表达水平升高(P＜0.05);预后不良患者龈沟液sST2、FGF21表达水平高于预后良好患者(P＜0.05);多因素logistic分析显示龈沟出血指数、探诊深度、龈沟液量、sST2、FGF21是种植体周围黏膜炎患者预后不良的危险因素(P＜0.05);ROC曲线结果表明,龈沟液sST2、FGF21两者联合预测种植体周围黏膜炎患者预后不良的曲线下面积(AUC)为0.920,显著大于sST2(Z=2.046,P=0.041)和FGF21(Z=2.407,P=0.016)单独预测。结论 牙种植体周围黏膜炎患者龈沟液中sST2、FGF21水平升高,二者联合对患者预后具有较高的预测效能。
Abstract
Objective To investigate the changes and clinical significance of soluble human matrix metalloproteinase-2 (sST2) and fibroblast growth factor 21 (FGF21) levels in gingival crevicular fluid of patients with periimplant mucositis. Methods A total of 97 patients with periimplant mucositis from June 2022 to June 2024 in the Third Medical Center of Chinese PLA General Hospital were selected as the observation group, Another 97 healthy natural tooth gingival volunteers were selected as the natural tooth control group, and 97 healthy peri implantitis gingival volunteers were selected as the implant control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of sST2 and FGF21 in gingival crevicular fluid of two groups. Multivariate logistic regression was applied to analyze the factors affecting poor prognosis in patients. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive ability of sST2 and FGF21 levels for poor prognosis. Results Compared with the natural tooth control group and the implant control group, the expression levels of sST2 and FGF21 in gingival crevicular fluid of patients in the observation group were increased (P<0.05). The expression levels of sST2 and FGF21 in gingival crevicular fluid of patients with poor prognosis were higher than those of patients with good prognosis (P<0.05). Multivariate logistic analysis showed that gingival bleeding index, probing depth, gingival crevicular fluid volume, sST2, and FGF21 were risk factors for poor prognosis in patients with periimplant mucositis (P<0.05). ROC curve results showed that the area under the curve (AUC) for predicting poor prognosis in patients with periimplant mucositis by combining sST2 and FGF21 in gingival crevicular fluid was 0.920, which was obviously larger than that predicted by sST2 alone (Z=2.046, P=0.041) and FGF21 alone (Z=2.407, P=0.016). Conclusion The levels of sST2 and FGF21 in gingival crevicular fluid of patients with periimplant mucositis are elevated, and the combination of the two has a high predictive power for prognosis.
关键词
牙种植体周围黏膜炎 /
龈沟液 /
可溶性人基质裂解素 /
成纤维细胞生长因子21
Key words
Periimplant mucositis /
gingival crevicular fluid /
soluble suppression of tumorigenicity 2 /
fibroblast growth factor 21
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