摘要
目的研究牙周炎伴高血压患者在龈上洁治术中血压升高的相关因素,并进一步分析具体原因。方法收集2019年1—11月就诊于青岛市口腔医院牙周科门诊,且患有慢性牙周炎伴原发性高血压的初诊患者,均通过清晨自行口服降压药血压控制在收缩压(SBP)159 mmHg或舒张压(DBP)99 mmHg以下患者212例。分析比较患者在超声龈上洁治术前和术中血压的变化,并根据术中较术前血压升高(DBP波动≥4 mmHg)进行分组:血压升高组和血压升高不明显组。分析两组之间血压变化与临床相关因素[性别、年龄、心率(HR)、精神紧张、就诊时间(上/下午)]的关系,并进行多因素Logistic回归分析。结果牙周炎伴高血压患者超声龈上洁治术中的收缩压和舒张压,心率均显著高于术前[SBP术中=(133.1±15.0)mmHg、SBP术前=(129.7±13.4)mmHg,DBP术中=(87.7±10.9)mmHg、DBP术前=(83.6±9.6)mmHg,HR术中=(77.4±11.3)次/分钟、HR术前=(74.2±9.9)次/分钟],差异均有统计学意义(P<0.05)。通过对血压升高组和血压升高不明显组之间临床资料的比较显示:年龄(t=2.49,P=0.013)、精神紧张(χ~2=16.27,P<0.001)、就诊时间(上/下午,χ~2=5.87,P<0.001)差异均有统计学意义,而性别差异无统计学意义(t=1.78,P=0.181)。多因素Logistic回归分析结果显示,牙周炎伴高血压患者在超声洁治术过程中,年龄(OR=1.033,95%CI=1.001~1.065)、心率加快(OR=4.073,95%CI=2.165~7.661)、精神紧张(OR=4.260,95%CI=2.226~8.152)、下午就诊(OR=2.376,95%CI=1.242~4.545)均是术中血压升高的相关因素(P<0.05)。结论牙周炎伴高血压患者超声龈上洁治术中血压升高与年龄、心率、精神紧张、就诊时间(上/下午)密切相关,值得临床重点关注。
Objective To study the related factors of elevated blood pressure in patients with periodontitis and hypertension during supragingival surgery and further analyze the specific reasons.Methods Newly diagnosed patients with chronic periodontitis and essential hypertension who visited the periodontal clinic of Qingdao Stomatological Hospital from January to November 2019 were collected and their blood pressure at systolic blood pressure(SBP)were under controlled through oral antihypertensive drugs in the morning.212 patients with 159 mmHg or diastolic blood pressure(DBP)below 99 mmHg were enrolled.The changes of blood pressure before and during the operation of ultrasound supragingival cleansing were analyzed and compared.The patients were classified into two groups:one group with blood pressure increase and the other group without significant increased according to the increase in blood pressure(DBP fluctuation≥4 mmHg)during the operation compared with the preoperative blood pressure.The relationship between blood pressure changes and clinical factors such as gender,age,heart rate(HR),emotional stress,morning/afternoon(AM/PM)between the two groups were analyzed and multivariate logistic regression analysis was applied.Results In patients with periodontitis and hypertension,the systolic and diastolic blood pressures during the ultrasound supragingival surgery,and the heart rate were significantly higher than those before the surgery[SBPIntraoperative=(133.1±15.0)mmHg,SBPPreoperative=(129.7±13.4)mmHg,DBP Intraoperative=(87.7±10.9)mmHg,DBPP reoperative=(83.6±9.6)mmHg,HR Intraoperative=(77.4±11.3)beats/min,HRPreoperative=(74.2±9.9)beats/min],and the differences were statistically significant(P<0.05).The comparison of clinical factors between the two groups showed statistically significant difference at age(t=2.49,P=0.013),emotional stress(χ~2=16.27,P<0.001),visit time(AM/PM)(χ~2=5.87,P<0.001),while the gender factor without statistically significant difference(t=1.78,P=0.181).The results of multivariate logistic regression analysis showed that the age(OR=1.033,95%CI=1.001-1.065)and increased heart rate(OR=4.073,95%CI=2.165)of patients with periodontitis and hypertension during the ultrasonic cleansing procedure(OR=4.073,95%CI=2.165-7.661),emotional/mental stress(OR=4.260,95%CI=2.226-8.152),and afternoon visits(PM)(OR=2.376,95%CI=1.242-4.545)are all related factors for increased blood pressure during surgery(P<0.05).Conclusion The elevation of blood pressure in patients with periodontitis and hypertension during the supragingival scaling are closely related to age,heart rate,emotional tension and treatment time(AM/PM),which is worthy of clinical attention.
作者
孟洋
王香兰
张晓敏
王万春
滕琦
孟焕新
Meng Yang;Wang Xianglan;Zhang Xiaomin;Wang Wanchun;Teng Qi;Meng Huanxin(Department of Periodontology,Qingdao Stomatological Hospital,Qingdao 266001,China;Department of Periodontology,Peking University School and Hospital of Stomatology,Beijing 100081,China)
出处
《中华口腔医学研究杂志（电子版）》
CAS
2020年第6期367-372,共6页
Chinese Journal of Stomatological Research(Electronic Edition)
基金
山东省医药卫生科技发展计划(2019WS150)
青岛市医疗卫生重点学科建设项目(2020⁃2022)
青岛市2019年度医药科研指导计划(2019⁃WJZD135)
青岛市市南区科技计划(2020⁃2⁃012⁃YY)。
