难治性根尖周炎根尖生物膜内粪肠球菌的检出及临床意义

doi:10.3877/cma.j.issn.1674-1366.2012.06.007

中华口腔医学研究杂志(电子版) ›› 2012, Vol. 06 ›› Issue (06) : 512 -515. doi: 10.3877/cma.j.issn.1674-1366.2012.06.007

临床研究

难治性根尖周炎根尖生物膜内粪肠球菌的检出及临床意义

孟磊¹, 卢志山¹^,^†(

), 柳忠豪¹, 张韬文¹, 任光辉¹

1.264008 滨州医学院附属烟台市口腔医院

收稿日期:2012-08-13 出版日期:2012-12-01
通信作者: 卢志山
基金资助:
烟台市科学技术发展计划（2007141）

Analysis of relationship between symptoms of the clinical patients and the detection of enterococcus faecalis in extraradicular biofilm of refractory periapical periodontitis

Lei MENG¹, Zhi-shan LU¹^,^†(), Zhong-hao LIU¹, Tao-wen ZHANG¹, Guang-hui REN¹

1.Yantai Stomatological Hospital Affiliated to Binzhou Medical College， Yantai 264008， China

Received:2012-08-13 Published:2012-12-01
Corresponding author: Zhi-shan LU

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目的

探讨难治性根尖周炎根尖生物膜内的粪肠球菌的检出率，分析粪肠球菌的检出率与临床表现的关系。

方法

按纳入标准收集需要进行根尖外科手术的单根管患牙42 颗，记录症状和体征，采集根尖生物膜样本，各样本均采用生化鉴定和聚合酶链反应（PCR）两种方法检测粪肠球菌。统计学分析两种方法对粪肠球菌的检出率差异及其与患者症状体征之间的关系。

结果

生化鉴定和PCR 检测难治性根尖周炎根尖生物膜内粪肠球菌的检出率分别为52.4%和71.4%，差异有统计学意义（P ＜0.05）。 PCR 检测发现在疼痛组粪肠球菌的检出率高于无疼痛组（P ＜0.05）。

结论

PCR 检测难治性根尖周炎根尖生物膜内粪肠球菌检出率较高，且粪肠球菌的检出与疼痛存在相关性。

关键词: 难治性根尖周炎, 根尖生物膜, 粪肠球菌

Objective

Identification and detection of Enterococcus faecalis （E.faecalis） isolated from extraradicular biofilm in refractory periapical periodontitis， in order to analyze the relationship between the occurrence of E.faecalis and clinical symptom.

Methods

Forty-two single root teeth which need periapical surgery were collected， and the clinical symptoms and physical signs were recorded.Bacterium samples from extraradicular biofilm were taken. The occurrence of E.faecalis by means of culture and polymerase chain reaction was investigated. The presence of E.faecalis and clinical signs was assessed to investigate the potential relationship between clinical findings.

Results

Culture and PCR revealed that the detection rates of E.faecalis was 52.4% and 71.4%， respectively， there was statistical significance （P ＜0.05）； The detection rates of E.faecalis by means of PCR between the pain and the painless group showed statistical significance （P ＜0.05）.

Conclusions

PCR was sensitive in detecting E.faecalis in root apex of refractory periapical periodontitis. The occurrence of E.faecalis in cases of refractory periapical periodontitis correlates with pain.

Key words: Refractory periapical periodontitis, Biofilm, Enterococcus faecalis

图1 粪肠球菌菌落形态肉眼观

图2 粪肠球菌革兰氏染色镜下观（×1000）

图3 难治性根尖周炎根尖生物膜粪肠球菌PCR 扩增产物的电泳结果 M：DNA 分子质量标准；1：阳性对照组；10：阴性对照组；2、4、6、7、8：粪肠球菌检出阳性；3、5、9：粪肠球菌检出阴性

表1 PCR 检测不同临床症状和体征的粪肠球菌检出情况

组别	病例数	检出例数	检出率（%）	χ ²	P
疼痛组	30	25	83.3	7.29	＜0.05
窦道组	11	7	63.6	0.07	＞0.05
无症状组	8	4	50.0	1.12	＞0.05

表1 PCR 检测不同临床症状和体征的粪肠球菌检出情况

组别	病例数	检出例数	检出率（%）	χ ²	P
疼痛组	30	25	83.3	7.29	＜0.05
窦道组	11	7	63.6	0.07	＞0.05
无症状组	8	4	50.0	1.12	＞0.05

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Analysis of relationship between symptoms of the clinical patients and the detection of enterococcus faecalis in extraradicular biofilm of refractory periapical periodontitis

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Analysis of relationship between symptoms of the clinical patients and the detection of enterococcus faecalis in extraradicular biofilm of refractory periapical periodontitis