Ефективність лікувальних заходів у пацієнтів із генералізованим пародонтитом на тлі цукрового діабету i типу з кардіоміопатією за окремими показниками ротової рідини

Abstract

Проаналізовано ефективність лікувальних заходів у пацієнтів із генералізованим пародонтитом на тлі цукрового діабету І типу з кардіоміопатією на зміни вмісту концентрацій ендотеліну-1 і метаболітів азоту в ротовій рідині в результаті застосування запропонованої авторами схеми в основній групі та в людей групи контролю, де лікування стоматологічної хвороби проводили за загальноприйнятою методикою. Доведено, що в пацієнтів основної групи внаслідок лікування суттєво підвищився вміст метаболітів азоту на тлі зниження концентрації ендотеліну-1 у ротовій рідині в порівнянні з даними в контролі; Проанализирована эффективность лечебных мероприятий у пациентов с генерализованным пародон- титом на фоне сахарного диабета І типа с кардиомиопатией на изменения содержания концентраций эндотелина-1 и метаболитов азота в ротовой жидкости в результате применения предложенной авторами схемы в основной группе и у людей группы контроля, где лечение стоматологической болезни проводили по общепринятой методике. Доказано, что у пациентов основной группы вследствие лечения существенно повысилось содержание метаболитов азота на фоне снижения концентрации эндотелина-1 в ротовой жидкости по сравнению с данными в контроле; Abstract. This paper analyzes the efficacy of therapeutic measures for patients with generalized periodontitis and type I diabetes mellitus with cardiomyopathy for changes in the content of concentrations of endothelin-1 and nitrogen metabolites in the oral liquid as the result of use developed own scheme in the main group and control group, where treatment of dental diseases carried out by generally accepted technique. It is proved that patients of the main group as a result of treatment were studied in a significant increase in the content of nitrogen metabolites in the context of reducing the concentration of endothelin-1 in the oral liquid compared to the data of control group. The purpose of this work was to study the changes of concentrations of nitrogen metabolites and endothelin-1 in the oral liquid, using own developed treatment and preventive complex in patients with generalized periodontitis in context of type 1 DM with cardiomyopathy. The material and research methods. The state of periodontal tissues in patients was evaluated by general accepted criteria of dental examination. Diagnosis of periodontal diseases was established according to the classification of M. F. Danilevsky (1994) with additions of I. S. Mashchenko (1997). The diagnosis was specified using periodontal indices. The complex treatment of generalized periodontitis within 127 patients group with generalized periodontitis in context of type 1 diabetes mellitus with cardiomyopathy, divided into two groups: main group (82 people) treatment conducted according to sekf- developed schemes. Control group the treatment of generalized periodontitis was performed according to the standard method by the "Protocols of medical care of Ministry of health of Ukraine on specialty "Therapeutic dentistry". The content of endothelin-1 in the oral fluid determined by ELISA method using a set of reagents. The content of nitrogen metabolites (NO2 + NO3) in the oral liquid of patients determined according to the standard method. The obtained results were statistically worked out. Results of the research and its discussion. Result of treatment and preventive measures for patients of the main group with GP after 6 months of treatment the content of nitrogen metabolites in the oral liquid has increased for all degrees of severity of generalized periodontitis compared to the values before treatment. Patients of control group with GP after 6 months of treatment, where used traditional therapeutic schemes, the content of nitrogen metabolites in the oral liquid was significantly lower at the initial stage – Ist degree of severity of GP relatively to the data before treatment (27.25±1.13 mkmol/l against 30.87±1.12 mkmol/l, p<0.05). Patients of the main group, after 12 months of treatment, demonstrated further decrease of endothelin-1 in the oral liquid relative to the data before treatment: at GP of the initial – Ist degree of severity by 43.84%, at GP of IInd degree of severity by 38.85% and at GP of IIIrd degree of severity by 23.61%, p<0.01. Within control group after 12 months of treatment the content of endothelin-1 was increased in the oral liquid by 21.43% more on initial stages of GP, p<0.05. In advanced forms of generalized periodontitis, the level of endothelin-1 was on 22.95% at GP of IInd degree of severity, p<0.01 and at GP of IIIrd degree of severity by 15.0% , p<0.05 higher relative to the data before treatment. Conclusions. The performed study proved the adequacy of the proposed treatment and preventive scheme in patients of the main group, which is confirmed by the improvement of endothelial function of the vessels of the periodontium, which is expressed by increasing in the concentrations of nitrogen metabolites in context of decrease of endothelin-1 in the oral liquid in this group of patients, in the absence of positive dynamics in the control group, where treatment was performed according to standard methods.