Abstract:

Objective    To explore the relationship between periodontitis and rheumatoid arthritis. Methods    Databases were electronically searched from PubMed （1966 to December 30， 2014）， EMBASE （1974 to December 30， 2014）， CNKI （1979 to December 30， 2014） and WanFang Data （1997 to December 30， 2014）， and the references listed in all papers were also retrieved. The literature was screened according to the inclusion and exclusion criteria by two reviewers independently； the methodology quality was evaluated after data abstraction，and then the RevMan 5.2 software was used for Meta-analyses. Results    Eight trials were included. Among the total 1068 patients involved，556 were rheumatoid arthritis patients， while the other 512 were non- rheumatoid arthritis patients. The results of Meta-analyses showed that：a）Clinical attachment loss（CAL）of the rheumatoid arthritis patients was more severe than that of the non- rheumatoid arthritis patients（MD=0.99，95％CI 0.81 to 1.77）；b）Periodontal depth（PD）of the rheumatoid arthritis patients was significantly higher than that of the non-rheumatoid arthritis patients（MD=0.74，95％CI 0.59 to 0.89）；c）Bleeding on probing （BOP）of the rheumatoid arthritis patients was more serious than that of the non-rheumatoid arthritis patients（MD=7.72，95％CI 5.66 to 9.78）；d） Gingival index （GI）of the rheumatoid arthritis patients was significantly higher than that of the non-rheumatoid arthritis patients（MD=0.24，95％CI 0.14 to 0.34）；e）There was no significant differences in plaque index （PI）between the two groups（MD=0.08，95％CI -0.13 to 0.28）. Conclusion    Rheumatoid arthritis patients are more prone to suffer from periodontitis or turn to the worse stage of periodontitis. In consideration of the factors such as small scales and incomplete measure indexes of the included studies， which have influences on the intensity and comprehensiveness of this conclusion， more high-quality studies are required. 

Key words: periodontitis, rheumatoid arthritis, Meta-analysis, case control study

摘要：

目的    系统评价牙周炎与类风湿关节炎（rheumatoid arthritis，RA）之间的关系。方法    计算机检索PubMed（1966年至2014-12-30）、EMBASE（1974年至2014-12-30）、CNKI（1979年至2014-12-30）和万方数字化期刊全文数据库（1997年至2014-12-30），并手工检索相关杂志及会议论文集中未发表的文献。由2位研究者按照纳入和排除标准筛选文献、提取资料并评价质量后，采用 RevMan 5.3软件进行Meta分析。结果    共纳入8个病例对照研究，合计1068例患者，其中RA组556例，非RA组512例。8个研究的合并分析结果显示，RA组临床附着丧失（CAL）程度重于非RA组，差异有统计学意义［MD=0.99，95％CI（0.81，1.77）］。6个研究的合并分析结果显示，RA组牙周袋深度（PD）大于非RA组，差异有统计学意义［MD=0.74，95％CI （0.59，0.89）］。5个研究的合并分析结果显示，RA组探针后出血（BOP）重于非RA组，差异有统计学意义［MD=7.72，95％CI （5.66，9.78）］。2个研究的合并分析结果显示，RA组牙龈指数（GI）水平高于非RA组，差异有统计学意义［MD=0.24，95％CI （0.14，0.34）］。3个研究的合并分析结果显示，RA组与非RA组之间的菌斑指数（PI）差异无统计学意义［MD=0.08，95％CI （-0.13，0.28）］。结论    RA患者更易罹患牙周炎或其牙周炎病情容易加重。鉴于本Meta分析纳入的研究数量较少且病例不多，以及测量指标不全面等影响论证强度及全面性的因素存在，以上结论尚需开展更多大样本、高质量、长期随访的研究来加以验证。

关键词: 牙周炎, 类风湿关节炎, Meta分析, 病例对照研究