COPD 患者の歯周状態、その治療の必要性、および気流制限と QOL との関連性

Periodontal Status, Its Treatment Needs, and Its Relationship with Airflow Limitation and Quality of Life in COPD Patients.

抄録

目的:

慢性閉塞性肺疾患（COPD）は，世界で最も多くみられる呼吸器疾患の一つである．COPD 患者の歯周病状態と気流制限には密接な関係があることが示唆されている．そこで本研究では，COPD 患者の歯周病状態とその治療の必要性，および気道閉塞の重症度やQOL との関連について検討することを目的とした．

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is one of the most prevalent respiratory diseases in the world. There is an impressive relationship between periodontal status and airflow limitation in patients with COPD. Therefore, in this study, we aimed to investigate the periodontal status, its treatment needs, and its relationship with the severity of airway obstruction and quality of life in patients with COPD.

材料および方法:

本研究では、健康な男性 36 名（対照群）および COPD 患者 35 名（症例群）を対象とした症例対照研究を実施した。COPD患者は、スパイロメトリー結果とGlobal Initiative for Chronic Obstructive Lung Disease（GOLD）基準に基づき、さらに4群に分類された。COPD Assessment Test（CAT）質問票を用い、参加者のQOLを評価した。その後，両群とも歯科医院に紹介し，専門医による歯周病状態の調査を行った．GOLD 分類，CAT スコア，FEV1/FVC 比，FEV1/FVC 比，FEV1 比，増悪率について，独立 t 検定，一元配置分散分析， Tukey's test および Pearson correlation coefficient により統計解析を行い，歯周病との関連性を検討した．

MATERIALS AND METHODS: In this case-control study, 36 healthy men (control group) and 35 men afflicted with COPD (case group) were investigated. On the basis of spirometry results and Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, patients with COPD were further divided into 4 groups. The participants' quality of life was evaluated using COPD Assessment Test (CAT) questionnaire. Thereafter, both groups of participants were referred to a dentistry clinic so that the related specialist could investigate their periodontal health status. The relationship between the periodontal indices and the variables under study including GOLD stage, CAT score, Forced Expiratory Volume in first second and Forced Vital Capacity (FEV1/FVC) ratio, Forced Expiratory Volume in first second (FEV1), and the exacerbation rate were statistically analyzed using independent t-test, one-way analysis of variance, Tukey's test, and Pearson correlation coefficient.

結果:

その結果，プロービングポケット深さ（PDD），プロービング時出血（BOP），LOA（Loss of attachment）はFEV1％と負の相関があり（r=-0.53，p=0.001），（r=-0.62，p=0.001），（r=-0.72，p=0.001），FEV1/FVC ratio（r=-0.45，p=0.007），（r=-0.47，p=0.004），（r=-0.61，p=0.001） とそれぞれ負の相関が認められた．また，PDD，BOP，LOAは，それぞれCATスコアと正の相関を示した（r=0.51，p=0.002），（r=0.47，p=0.004），（r=0.71，p=0.001）．

RESULTS: The results revealed that probing pocket depth (PDD), bleeding on probing (BOP), and loss of attachment (LOA) are negatively correlated with FEV1% (r=-0.53, p=0.001), (r=-0.62, p=0.001), and (r=-0.72, p=0.001) as well as FEV1/FVC ratio (r=-0.45, p=0.007), (r=-0.47, p=0.004), and (r=-0.61, p=0.001), respectively. The results showed that PDD, BOP, and LOA are positively correlated with CAT score (r=0.51, p=0.002), (r=0.47, p=0.004), and (r=0.71, p=0.001), respectively.

結論:

歯周病は COPD の重症度（GOLD 基準）と正の相関があり，COPD 患者の QOL と負の相関があることが示唆された．

CONCLUSION: Periodontal problems are positively associated with COPD severity as determined by GOLD criteria and negatively associated with quality of life of patients with COPD.