Objective To observe the histological changes in periodontal tissue and the serum levels of tumor necrosis factor?alpha (TNF?α),interleukin?6(IL?6),plasminogen activator inhibitor?1(PAI?1)in type 2 diabetic rats with periodontitis,and to investigate the influence of expression of TNF?α,IL?6 and PAI?1 on the histological changes of periodontal tissue remodeling in periodontitis rats with type 2 diabetes mellitus.Methods Sixty SD Wistar rats aged 8~9 weeks were divided into four groups according to different mod?eling methods:①diabetic rats with periodontitis group(n=15);②diabetic rats without periodontitis group(n=15);③non?diabetic rats with periodontitis group(n=15);④ non?diabetic rats without periodontitis group(n=15). Diabetic model was established by in?traperitoneal injection of streptozotocin(STZ). Diabetes was determined by measuring blood glucose in rat tail vein once a week after giving the drug and for four successive weeks. The rat experimental periodontitis was induced by wrapping 3/0 silk ligature inoculated with Porphyromonasgingivalis around the left maxillary second molar of the rats and then the model was copied. The rats were sacrificed at 20th week after ligature by intraperitoneal injection of chloral hydrate. The blood was collected from aorta abdominalis. Then serum levels of TNF?α,IL?6 and PAI?1 were measured with ELISA method.The attachment loss(AL)was measured before sacrifice.The his?tological changes of periodontal tissues were observed under microscope with HE staining. Results The diabetic rats showed a signifi?cant increase in blood glucose and weight(P<0.05).The serum insulin level and insulin resistance values of the diabetic rats signifi?cantly increased(P<0.05). The rat experimental periodontitis showed typical clinical characteristics of periodontitis after ligature inocu?lated with Porphyromonasgingivalis. The levels of serum TNF?α, IL?6 and PAI?1 were significantly higher in diabetic rats with peri?odontitis than those in diabetic rats without periodontitis group(P<0.05).Conclusion Diabetes can decrease the periodontal tissue re?sistance to local pathogenic factors by promoting the expression of serum inflammatory factors,thereby further aggravating and accelera?ting the progress of periodontitis.%目的 观察2型糖尿病伴牙周炎大鼠牙周组织及血清肿瘤坏死因子-α(TNF?α)、白细胞介素?6(IL?6)及纤溶酶原活化物抑制因子?1(PAI?1)水平的变化,探讨TNF?α、IL?6及PAI?1的表达对2型糖尿病牙周炎大鼠牙周组织改建过程中组织变化的影响.方法 清洁级8~9周龄Wistar大鼠60只,分为4组:①伴牙周炎糖尿病组(n=15);②不伴牙周炎糖尿病组(n=15);③伴牙周炎非糖尿病组(n=15);④不伴牙周炎非糖尿病组(正常对照组,n=15).采用腹腔内注射链脲佐菌素(strepto?zotocin,STZ)法建立大鼠糖尿病模型.给药后每周1次,连续4周测定大鼠尾静脉血糖水平,以判断大鼠糖尿病建模情况.用浸有牙龈卟啉单胞菌株的丝线结扎左侧上颌第二磨牙牙颈部,复制实验性牙周炎模型.实验性牙周炎建模20周后,采用腹腔注射水合氯醛法在全麻状态下处死大鼠.从腹主动脉采集血液,ELISA法检测血清TNF?α、IL?6及PAI?1水平.处死前测量术区的牙周附着情况.制作牙体牙周联合切片,观察牙周组织学改变.结果 糖尿病组大鼠表现为血糖和体质量水平显著升高(P<0.05);糖尿病组大鼠血清胰岛素水平和胰岛素抵抗指数得分均显著升高(P<0.05);用浸有牙龈卟啉单胞菌株的丝线结扎后,牙周炎组表现为典型的牙周炎临床特征;与不伴牙周炎糖尿病组相比,伴牙周炎糖尿病组大鼠血清TNF?α、IL?6及PAI?1水平显著升高(P<0.05).结论 糖尿病通过促进血清炎性因子的表达,降低牙周组织对局部致病因子的抵抗力,从而加重、加速牙周炎的进展.
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