Objective: To study and explore the prevalence, characteristics, preliminary risk factors, as well as their relationship with nutritional scores in liver cirrhotic patient with chronic periodontitis. Methods: 163 patients with liver cirrhosis who were hospitalized in the Hepatology Division, Department of Internal Medicine at Tianjin Third Central Hospital from June to September 2018 were enrolled as the case group, while the control group consisted 140 healthy individuals enrolled during the same period. Periodontal examination, biochemical examination and oral hygiene habits were investigated. The prevalence of periodontitis in the two groups was compared, and the risk factors of severe periodontitis were conducted by multivariate regression analysis. Results: The prevalence of chronic periodontitis was significantly higher in patients with liver cirrhosis than healthy control population, and the differences were statistically significant (P < 0.05). The prevalence of severe periodontitis and full edentulous jaws was significantly higher in patients with liver cirrhosis than healthy control group, and the differences were statistically significant (P < 0.05 and P < 0.001). Compared with the healthy control group, the depth of periodontal pocket and the degree of attachment loss were significantly increased in the liver cirrhosis group (P < 0.001). Multivariate regression analysis showed that liver cirrhosis was the independent risk factors for both groups of patients with severe periodontitis (χ (2) = 11.046, P < 0.001). Univariate and multivariate regression analysis showed that toothbrushing frequency, nutritional risk score, prealbumin level and Child-Pugh grade were independent risk factors for occurrence of severe periodontitis in liver cirrhotic patient (χ (2) = 5.252, P = 0.022; χ (2) = 24.162, P < 0.001; χ (2) = 4.159, P = 0.041; χ (2) = 9.249, P = 0.002). Conclusion: The prevalence of periodontitis is significantly higher in patients with liver cirrhosis than healthy individuals, and liver cirrhosis is an independent risk factor for the occurrence of severe periodontitis. Toothbrushing frequency, nutritional risk score, prealbumin level and Child-Pugh grade are risk factors for severe periodontitis in patients with liver cirrhosis.
目的： 研究肝硬化患者中慢性牙周炎的发病情况及特点，初步探讨肝硬化患者牙周炎发病的风险因素及其与营养评分的关系。 方法： 纳入2018年6月至9月天津市第三中心医院肝内科住院治疗的肝硬化患者163例及同期该院140例健康体检人群，进行牙周检查、生物化学检查及口腔卫生习惯的调查。对2组人群的牙周炎患病情况进行比较，并对重度牙周炎的风险因素进行多因素回归分析。 结果： 肝硬化患者中慢性牙周炎患病率明显高于健康人群，差异具有统计学意义（P < 0.05）。肝硬化患者的重度牙周炎患病率及全口无牙颌的发生率明显高于健康对照组，差异均具有统计学意义（分别为P < 0.05及P < 0.001）。与健康对照组相比，肝硬化组患者牙周袋深度及附着丧失程度均明显升高(P < 0.001）。对2组重度牙周炎患者进行多因素回归分析，肝硬化为独立于其他因素的重度牙周炎的风险因素（χ(2) = 11.046，P < 0.001）。对肝硬化发生重度牙周炎的患者进行单因素及多因素回归分析，提示刷牙次数、营养风险评分、前白蛋白水平及Child-Pugh分级是重度牙周炎发生的独立风险因素（分别为χ(2) = 5.252，P = 0.022；χ(2) = 24.162，P < 0.001；χ(2) = 4.159，P = 0.041；χ(2) = 9.249，P = 0.002）。 结论： 肝硬化患者牙周炎的患病率明显高于健康人群，肝硬化为重度牙周炎发生的独立风险因素，刷牙次数、营养风险评分、前白蛋白水平及Child-Pugh分级是肝硬化患者重度牙周炎的风险因素。.
Keywords: Attachment loss; Chronic periodontitis; Liver cirrhosis; Nutritional risk score; Periodontal pocket depth.