| Objective:This study was to explore the curative effect of non-surgical periodontal therapy(NSPT)in patients with coronary heart disease(CHD)associated with chronic periodontitis(CP),the influence of the index of the present study mainly includes:serum high sensitive C-reactive protein(hs-CRP),interleukin-8(IL-8),tumor necrosis factor-alpha(TNF-α),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL),low-density lipoprotein(LDL),to explore whether NSPT could control local inflammation and systemic inflammation to some extent,so as to provide a new idea for the study of the correlation between oral diseases and systemic diseases.Methods:By searching Pub Med,Cochrane Library,Web of Science,Ovid,Science Direct,Embase,CNKI(China National Knowledge Internet),Wanfang and VIP databases,we collected the clinical randomized controlled trials on the effects of NSPT on systemic inflammation in patients with CHD with CP from the self-established databases to September 2020.At the same time,the references of related literature were searched.According to the inclusion and exclusion criteria,two researchers independently screened the literatures and extracted the basic information and data of the included articles.The risk assessment tool recommended by the Cochrane Collaboration was used to assess the risk of methodological bias in the included studies.This study chooses the weighted mean difference(WMD)and 95%confidence interval(CI)said effect quantity,Q test and I~2 test were used to test heterogeneity into article inspection,according to the size of the heterogeneity choose random effect model or fixed effect model to analyze consolidation effect quantity,Begg’s test is used to test the publication bias,by changing the effect of model to test the combined effects of sensitivity,and this meta-analysis was performed using STATA(version 16.0)software.Results:1.A total of 1331 patients were included in 16 articles that met the inclusion and exclusion criteria.2.Meta-analysis of hs-CRPThere was no statistical differences of the changes of serum hs-CRP after1-month follow-up(WMD=-0.81,95%CI range-1.80 to 0.18,P=0.108;χ~2=7.71,P=0.021,I~2=74.1%).The changes of serum hs-CRP after 3-month follow-up(WMD=-1.00,95%CI range-1.92 to-0.08,P=0.033;χ~2=23.56,P<0.001,I~2=83.0%)were statistically significant.The changes of serum hs-CRP after 6-month follow-up(WMD=-0.40,95%CI range-0.50 to-0.29,P<0.001;χ~2=0.05,P=0.831,I~2=0%)were statistically significant.3.Meta-analysis of IL-8The changes of IL-8 after 1-month follow-up(WMD=-3.18,95%CI range-5.75 to-0.60,P=0.016;χ~2=0.02,P=0.882,I~2=0%)were statistically significant.The changes of IL-8 after 3-month follow-up(WMD=-4.30,95%CI range-7.27 to-1.34,P=0.004;χ~2=0.26,P=0.613,I~2=0%)were statistically significant.4.Meta-analysis of TNF-αThe changes of TNF-αafter 1-month follow-up(WMD=-5.19,95%CI range-6.67 to-3.71,P<0.001;χ~2=0.34,P=0.559,I~2=0%)were statistically significant.The changes of TNF-αafter 3-month follow-up(WMD=-3.93,95%CI range-7.56 to-0.30,P=0.034;χ~2=14.35,P=0.002,I~2=79.1%)were statistically significant.5.Meta-analysis of blood lipidsThe changes of TG after 1-month follow-up(WMD=-0.21,95%CI range-0.35 to-0.07,P=0.003;χ~2=0.09,P=0.762,I~2=0%)were statistically significant.There was no statistical differences of the changes of TG after3-month follow-up(WMD=-0.07,95%CI range-0.25 to 0.11,P=0.442;χ~2=2.44,P=0.655,I~2=0%).There was no statistical differences of the changes of TG after 6-month follow-up(WMD=-0.24,95%CI range-0.48 to 0.00,P=0.053;χ~2=0.20,P=0.658,I~2=0%).There was no statistical differences of the changes of TC after 1-month follow-up(WMD=-0.00,95%CI range-0.21 to 0.21,P=0.970;χ~2=0.01,P=0.940,I~2=0%).There was no statistical differences of the changes of TC after 3-month follow-up(WMD=-0.10,95%CI range-0.29 to 0.08,P=0.275;χ~2=3.00,P=0.392,I~2=0%).The changes of TC after 6-month follow-up(WMD=-0.50,95%CI range-0.88 to-0.11,P=0.011;χ~2=1.66,P=0.197,I~2=39.8%)were statistically significant.There was no statistical differences of the changes of HDL after 1-month follow-up(WMD=0.02,95%CI range-0.05 to 0.10,P=0.542;χ~2=0.08,P=0.779,I~2=0%).There was no statistical differences of the changes of HDL after 3-month follow-up(WMD=-0.05,95%CI range-0.12 to 0.03,P=0.255;χ~2=1.29,P=0.525,I~2=0%).There was no statistical differences of the changes of LDL after 1-month follow-up(WMD=0.01,95%CI range-0.18 to 0.19,P=0.955;χ~2=0.13,P=0.723,I~2=0%).There was no statistical differences of the changes of LDL after 3-month follow-up(WMD=0.01,95%CI range-0.18 to 0.19,P=0.832;χ~2=15.49,P<0.001,I~2=87.1%).6.According to the test,the results of each observational indicator in this meta-analysis did not have publication bias.Sensitivity analysis showed that hs-CRP of patients followed up for 1 month after NSPT was poor in stability,while other results were good in stability.Conclusions:1.The results of this meta-analysis showed that TNF-α,IL-8,and TG in patients with CHD with CP after NSPT were better than those in the group without NSPT at 1-month follow-up period.The clinical efficacy of hs-CRP,TNF-αand IL-8 in patients with CHD with CP after NSPT was better than that in the group without NSPT at 3-month follow-up period.The clinical efficacy of hs-CRP and TC in patients with CHD with CP after NSPT was better than that in the group without NSPT at 6-month follow-up period.2.At 1-month,the clinical efficacy of hs-CRP,TC,HDL and LDL in patients with CHD and CP after NSPT showed no statistical difference compared with the patients without NSPT.At 3-month,the clinical efficacy of TC,TG,HDL and LDL in patients with CHD and CP after NSPT showed no statistical difference compared with the patients without NSPT.At 6-month,the clinical efficacy of TG in patients with CHD and CP after NSPT showed no statistical difference compared with the patients without NSPT.3.There are still few high-quality literatures on the efficacy of NSPT in patients with CHD with CP,and more large sample size,long-term observation,and high-quality clinical randomized controlled trials are still needed for research. |
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