关键词: 牙周炎, 卒中, 认知, 白细胞介素10, 肿瘤坏死因子α, C-反应蛋白, 老年, 相关性分析

Abstract: Objective　To explore the changes of peripheral blood inflammatory markers in elderly patients with stroke sequelae and periodontitis and the correlation with their cognitive function. Methods　A total of 68 elderly patients with chronic stroke and periodontitis were selected. All of the patients received standard treatment for periodontitis. According to whether periodontitis persisted after 6 months of treatment, the patients were divided into periodontitis present group (n=33) and cure group (n=35). The serum levels of C-reactive protein (CRP), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), MMSE score and ADAS-cog score before and after treatment were compared between the two groups. The correlation between the variation values of CRP, IL-10, TNF-α and the variation values of MMSE score, ADAS-cog score before and after treatment were explored by Spearman correlation analysis. The influencing factors of the variation values of MMSE score, ADAS-cog score before and after treatment were explored by multiple linear regression analysis. Results　After 6 months of treatment, the levels of CRP, IL-10 and TNF-α were significantly higher in the periodontitis present group than those in the cure group (P＜0.05). Compared with before treatment, after 6 months of treatment, the levels of CRP, IL-10 and TNF-α were significantly increased in the periodontitis present group, while CRP was significantly decreased in the cure group (P＜0.05). After 6 months of treatment, MMSE score and ADAS-cog score were significantly lower in the periodontitis present group than those in cure group (P＜0.05). Compared with before treatment, after 6 months of treatment, MMSE score and ADAS-cog score were significantly decreased in the periodontitis present group (P＜0.05). Spearman correlation analysis showed that the variation values of CRP, IL-10, TNF-α were negatively correlated with the variation values of MMSE score and ADAS-cog score. Multivariate linear regression analysis showed that persistent periodontitis was the independent influencing factor for the variation values of MMSE score and ADAS cog score before and after treatment (P＜0.05). Conclusion　Periodontitis is associated with the further decline of the cognitive function in elderly patients with stroke sequelae, which possibly through the effects of systemic inflammation.

Key words: periodontitis, stroke, cognition, interleukin-10, tumor necrosis factor-alpha, C-reactive protein, elderly, correlation analysis