【摘要】 目的  通过检测糖尿病伴牙周炎患者全唾液中牙周致病菌的种类和数量，探讨伴该类患者口腔中菌斑微生物的构成及数量特点，分析牙周炎严重程度及血糖控制情况对全唾液中牙周致病菌群的影响。 方法  采用病例对照研究，纳入糖尿病合并牙周炎患者（DM+CP）24例，单纯牙周炎患者（CP）30例及健康者（NC）30名。收集静息全唾液，采用以16SrRNA为基础的PCR检测全唾液中牙龈卟啉单胞菌（Pg）、中间型普里沃氏菌（Pi）、福塞坦氏菌（Tf）。 结果  与NC组比较，DM+CP与CP组3种牙周致病菌检出率及相对含量升高（P＜0.05）。DM+CP组Tf检出率（33%）低于CP组（63%）（P＜0.05）。与CP组中重度牙周炎患者比较，DM+CP组HbA1c≥6.5%及HbA1c≥6.5%%者Tf检出率及相对含量降低（P＜0.05）。DM+CP及CP组中重度牙周炎症患者Pg与Pi检出率及相对含量均高于轻度牙周炎症患者。 结论  随着系统性糖代谢水平的异常，继而导致全身微环境的改变，最终对牙周局部菌斑微生物的定植产生影响。

   【关键词】糖尿病；牙周炎；全唾液；牙周可疑致病菌

       Detection of periodontal pathogens in whole saliva of diabetic patients with periodontitis and its clinical significance

   【Abstract】 Objective  To explore the composition and amount of plaque microorganism in whole saliva of diabetic patients with periodontitis and the effect of periodontitis severity and glycemic control on perio-dontal pathogens.  Methods  Case-control study was conducted. A total of 84 participants were selected and divided into three groups: diabetes with periodontitis group(DM+CP, n=24), simple periodontitis group(CP, n=30) and healthy group (NC, n=30). The resting whole saliva of subjects was collected. Porphyromonasgingivalis (Pg), prevotellaintermedia (Pi) and tannerellaforsythia (Tf) were detected by PCR (polymerase chain reaction) tec-hnique based on 16SrRNA.  Results  The detection rate and relative content of the three periodontal bacteria were significantly higher in DM+CP and CP groups than in NC group(P<0.05).  The detection rate of Tf was si-gnificantly lower in DM+CP group（33%）than in CP group（63%）(P<0.05). The detection rate and relative content of Tf were significantly lower in patients with HbA1c<6.5% or HbA1c≥6.5% in DM+CP group than in patients with severe periodontitis in CP group. The detection rates and relative contents of Pg and Pi were higher in patien-ts with severe periodontitis than in patients with mild periodontitis in DM+CP and CP groups.  Conclusion  The abnormal glucose metabolism in the whole body can lead to the change of systemic microenvironment, and ultimately influence the colonization of local periodontal plaque microorganism.

   【Key words】 Diabetes mellitus; Periodontitis; Whole saliva; Suspected periodontal bacteria