孕酮(PG)是一种重要的性类固醇激素,通常用于保护围绝经期妇女的子宫内膜。本研究旨在探讨围绝经期妇女牙周炎对PG的差异反应,这些妇女曾或未经历过刮除和根面平整(SRP)。
■共纳入129名患有轻度至中度牙周炎的围绝经期妇女,并接受如下治疗:SRP(n=35);SRP+PG(n=34);PG(n=31);无治疗(n=29)。口袋探测深度(PPD),临床依恋水平(CAL),沟出血指数(SBI),使用牙周探针测量探查出血(BOP)。三种炎症标志物,包括C反应蛋白(CRP),使用ELISA技术测量龈沟液(GCF)中的白细胞介素(IL)-6和肿瘤坏死因子-α(TNF-α)。
■PPD,CAL,SBI,防喷器,围绝经期牙周炎妇女SRP术后GCF中炎性因子水平均明显降低。在没有接受SRP的患者中,6个月的PG治疗显著升高PPD,SBI,防喷器,和GCF的CRP水平,IL-6和TNF-α。相比之下,PG对接受SRP的患者牙周炎症表现出抑制作用,BOP和IL-6显著下降,SBI略有下降,CRP,和TNF-α。PG诱导的变化在PG停药后6个月(12个月时)消失。
■在患有牙周炎的围绝经期妇女中,PG在没有SRP的情况下增强了牙周炎症,但在接受SRP的患者中抑制了牙周炎症。
Progesterone (PG) is an important sex steroid hormone commonly administered to protect the endometrium in perimenopausal women. The present study aimed to explore differential responses of periodontitis to PG in perimenopausal women who did or did not undergo scaling and root planing (SRP).
A total of 129 perimenopausal women with mild-to-moderate periodontitis were enrolled and underwent treatment as follows: SRP (n = 35); SRP + PG (n = 34); PG (n = 31); and no treatment (s) (n = 29). Pocket probing depth (PPD), clinical attachment level (CAL), sulcus bleeding index (SBI), and bleeding on probing (BOP) were measured using periodontal probes. Three inflammatory markers, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF) were measured using ELISA techniques.
PPD, CAL, SBI, BOP, and levels of inflammatory factors in GCF were all significantly decreased in perimenopausal women with periodontitis after SRP. In patients who did not undergo SRP, 6 months of PG treatment significantly elevated PPD, SBI, BOP, and GCF levels of CRP, IL-6, and TNF-α. In contrast, PG exhibited inhibitory effects on periodontal inflammation in patients who underwent SRP, evidenced by significantly decreased BOP and IL-6, and slightly decreased SBI, CRP, and TNF-α. PG-induced changes dissipated 6 months after withdrawal of PG (at 12 months).
Among perimenopausal women with periodontitis, PG enhanced periodontal inflammation in the absence of SRP but inhibited periodontal inflammation in those who underwent SRP.