冠状动脉粥样硬化斑块中牙周致病菌的检测及研究-心血管内科学专业论文.docxVIP

PAGE PAGE 1 摘 要 冠状动脉粥样硬化斑块中牙周致病菌的检测及研究 研究生：梁 平 导 师：张源明 教授 摘 要 目的：从冠状动脉粥样硬化斑块中是否能检测出牙周特异性致病菌-牙龈卟啉单胞 菌（P.g）、中间普氏菌（P.i）、福赛类杆菌（T.f）、具核梭杆菌（F.n）、伴放线放线杆 菌（A.a）,同时比较同一患者动脉粥样硬化斑块及其龈下菌斑中的牙周致病菌的同源 性，以探讨冠心病和慢性牙周炎之间可能的关系。方法：选择51例在新疆医科大学心 外科行冠状动脉搭桥术的冠心病患者,术前及术中分别收集龈下菌斑和冠状动脉粥样 硬化斑块，用Chelex-100法提取细菌的DNA，采用牙周致病菌特异性引物，通过聚合 酶链反应(polymerase chain reaction,PCR)技术，检测粥样硬化斑块及龈下菌斑中特异性 牙周致病菌的DNA，并对扩增产物测序，与数据库进行比对,根据比对结果确定扩增 产物是否来源于牙周特异性致病菌。结果：从冠状动脉粥样硬化斑块及龈下菌斑中成 功扩增特异产物,测定序列与数据库比对,能确定病原菌的种类。51例冠状动脉粥样硬 化斑块中，P.g的阳性率33%，T.f的阳性率31%，P.i的阳性率18%，F.n的阳性率12%。 从51例粥样硬化斑块中未检测出A.a；51例龈下菌斑中，T.f阳性率84%，F.n阳性率78%， P.i阳性率59%，P.g阳性率39%，A.a阳性率22%；结论：冠状动脉粥样硬化斑块中能检 测出牙周致病菌,动脉粥样硬化斑块及龈下菌斑中检测的病原菌DNA有高度同源性。证 明牙周致病菌在冠状动脉粥样硬化发生、发展过程中起一定的作用，可能和冠心病发 病相关。 关键词：冠状动脉粥样硬化斑块； 牙菌斑； PCR 技术； 基因测序； 基因同源性 新疆医科大学医学硕士学位论文 A Study on the relationship between coronary atheromatous plaques and periodontal pathogenic bacterias Postgraduate:LiangPing Supervisor:Zhang Yuanming Professor Abstract Objective: The aim of this study was to ascertain the presence of periodontal bacteria DNA（Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Porphyro- monas gingivalis, Prevotella intermedia, Tannerella forsythensis）in coronary atheromatous plaques and to compare them with periodontal bacteria from the subgingival plaque sample obtained from the same patients. Methods: A total of 51 patients scheduled for coronary artery bypass graft were enrolled in this study.Coronary atheromatous plaques and subgingival plaque samples were examined using the polymerase chain reaction (PCR) technique by means of specific primers for periodontal bacteria. The products of amplification were sequenced and compared with those in database so as to determine whether the products of amplification were derived from periodontal bacterias. Results: the sequences of periodontal bacteria DNA in atheromatous plaques could be ascertained the truth by DNA sequencing in this study and we could compare them with type strains sequences from the GenBank by BLAST to