女性实验室检查对牙周病合并细菌性阴道病治疗动态的诊断价值

T. Petrushanko, A. Krutikova, E. Krutikova
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引用次数: 0

摘要

尽管有证据表明细菌性阴道病患者存在慢性全身炎症和炎症性营养不良牙周病,但由于缺乏明确的细菌性阴道疾病(BV)女性牙科筛查策略,导致治疗计划不足,因为没有考虑非典型触发因素,在非侵入性诊断中至关重要。在这方面,α-淀粉酶和分泌型IgA(sIgA)值得注意。研究的目的。本文旨在通过测定α-淀粉酶的动力学活性和sIgA浓度的变化,验证最近治疗育龄妇女细菌性阴道病的炎症性和炎症性营养不良牙周病的结果评估的诊断价值。材料和方法。对50名育龄妇女进行了检查。受试者根据其妇科状况分为几组:第一组(对照组)(n=10)包括阴道纯度为I和II级的女性;A组(n=15)包括经证实诊断为BV并接受常规治疗的女性;第一组-B(n=15)包括患有BV的女性,她们使用我们的专利治疗方案接受治疗,该方案考虑到了这组受试者口腔中存在的特定BV菌群。在口腔中,分析口腔液的氨基测试结果,并测定α-淀粉酶的动力学活性和sIgA浓度。采用聚合酶链式反应(PCR)方法检测口腔中是否存在阴道加德纳菌和阴道阿托菌。后果患有BV的女性的sIgA水平比没有BV的患者低30-45%。两组女性的口服sIgA浓度在治疗后都恢复了,但III-A组和III-B组在治疗后的结果有显著差异(III-B组受试者sIgA的结果比III-A组的值高1.33倍),表明考虑到口腔中BV病原体的存在的所提出的治疗方案具有更高的疗效。III-A组患者在治疗前口腔液氨基测试结果呈阳性的比例为73.3%,治疗后仅为53.3%,而III-B组受试者的初步结果为80%;治疗后,记录到下降到20%。结论。应用实验室方法检查女性局部耐药性的诊断价值足以作为炎症和炎症性营养不良牙周病伴细菌性阴道病患者牙周治疗结果的对照。
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DIAGNOSTIC VALUE OF LABORATORY TESTS OF WOMEN IN THE DYNAMICS OF TREATMENT OF PERIODONTAL DISEASES CONCOMITANT WITH BACTERIAL VAGINOSIS
The lack of clear dental screening strategy for women with bacterial vaginosis (BV) leads to inadequate treatment planning, since atypical triggering factors are not considered, despite the given evidence for the presence of chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases in patients with BV. The analysis of the oral fluid, especially its protective properties, is crucial in the noninvasive diagnostics. In this regard, alpha-amylase and secretory IgA (sIgA) are noteworthy. The aim of the research. The paper was aimed at verification of the diagnostic value of the assessment of the outcomes of the recent treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women of reproductive age with bacterial vaginosis by determining the changes in the kinetic activity of alpha- amylase and sIgA concentration. Material and Methods. 50 women of reproductive age have been examined. The subjects were assigned into groups according to their gynecological status: Group I (control) (n=10) included women with the I and II degree of purity of the vagina Group II (n=10) included carriers of Gardnerella vaginalis without diagnosed bacterial vaginosis ; Group ІІІ-A (n=15) included women with verified diagnosis of BV who received conventional treatment; Group IІІ-B (n=15) included women with BV, who received treatment using our patented treatment regimen that takes into account the presence of specific BV-microflora found in the oral cavity in this group of subjects. In the oral cavity the results of the amino-test of the oral fluid were analyzed and kinetic activity of alpha-amylase and sIgA concentration was determined. The presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity was determined by the polymerase chain reaction (PCR) method. Results. The sIgA level of women with BV was by 30-45% lower as compared to the value of patients without BV. Concentration of oral sIgA in both groups of women was restored after treatment, but the results of the III-A and III-B groups after treatment significantly differed (the result of sIgA in subjects of Group III-B was by 1.33 times higher than the value of Group III-A), indicating the higher efficacy of the proposed treatment regimen, which takes into account the presence of etiological agents of BV in the oral cavity. The results of the amino test of oral fluid were positive in patients of Group III-A before treatment in 73.3%, after treatment only in 53.3%, while in the subjects of Group III-B the initial result was 80%; after treatment, a decrease to 20% was registered. Conclusions. The diagnostic value of the applied laboratory methods for examination of local resistance in women is sufficient for mass use as a control of the results in periodontal treatment of patients with inflammatory and inflammatory-dystrophic periodontal diseases concomitant with bacterial vaginosis.
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