摘要： 目的：探讨TLR4/MyD88信号通路在2型糖尿病并慢性牙周炎发病中的作用。方法：选取2017-02—2018-02在我院内分泌科治疗的2型糖尿病患者157例，其中伴慢性牙周炎患者114例（合并组），单纯2型糖尿病患者43例（糖尿病组）。同期选取慢性牙周炎患者45例（慢性牙周炎组）和健康者40例（健康组）。收集临床资料，采用酶联免疫吸附试验（enzyme linked immunosorbent assay，ELISA）检测血清中TLR4、MyD88、TNF-α、IL-1β和IL-6水平。结果：合并组和糖尿病组患者FG和HbAlc均高于慢性牙周炎组和健康组（P<0.05），而HDL-C低于慢性牙周炎组和健康组（P<0.05），合并组患者CRP高于糖尿病组、慢性牙周炎组和健康组（P<0.05）；合并组牙齿数少于糖尿病组、慢性牙周炎组和健康组（P<0.05），合并组改良出血指数、PD和AL高于糖尿病组和健康组（P<0.05）；合并组血清中TLR4、MyD88、TNF-α、IL-1β和IL-6水平均高于糖尿病组、慢性牙周炎组和健康组（P<0.05），糖尿病组和慢性牙周炎组血清中TLR4、MyD88、TNF-α、IL-1β和IL-6水平无差异（P>0.05），而均高于健康组（P<0.05）。结论 2型糖尿病并慢性牙周炎患者血清中TLR4、MyD88、TNF-α、IL-1β和IL-6水平升高，TLR4/MyD88信号通路介导的炎症反应可能参与了该病的发生及病情进展。

关键词: 2型糖尿病, 慢性牙周炎, TLR4/MyD88信号通路, 炎症反应

Abstract: Objective：To investigate the role of TLR4/MyD88 signaling pathway in the pathogenesis of type 2 diabetes mellitus with chronic periodontitis. Methods：A total of 157 patients with type 2 diabetes mellitus who were treated in our department were selected from February 2017 to February 2018, including 114 patients with chronic periodontitis (combined group) and 43 patients with type 2 diabetes alone (diabetes group). In the same period, 45 patients with chronic periodontitis (chronic periodontitis group) and 40 healthy patients (healthy group) were selected. Clinical data was collected. The levels of TLR4, MyD88, TNF-α, IL-1β and IL-6 in serum were detected by enzyme linked immunosorbent assay (ELISA). Results：The FG and HbAlc in the combined group and the diabetes group were higher than those in the chronic periodontitis group and the healthy group (P<0.05), while the HDL-C was lower than that in the chronic periodontitis group and the healthy group (P<0.05), CRP in the combined group was higher than that in the diabetes group, chronic periodontitis group and healthy group (P<0.05). The number of teeth in the combined group was less than that in the diabetes group, chronic periodontitis group and healthy group (P<0.05). The modified bleeding index, PD and AL in the combined group were higher than those in the diabetes group and the healthy group (P<0.05). The levels of TLR4, MyD88, TNF-α, IL-1β and IL-6 in the serum in the combined group were higher than those in the diabetes group, chronic periodontitis group and healthy group (P<0.05). There were no significant differences in levels of TNF-α, IL-1β and IL-6 in serum between the diabetes group and the chronic periodontitis group (P>0.05), but which were higher than the healthy group (P<0.05). Conclusion：The levels of TLR4, MyD88, TNF-α, IL-1β and IL-6 in serum were elevated in patients with type 2 diabetes mellitus with chronic periodontitis. TLR4/MyD88 signaling pathway-mediated inflammation might be involved in onset and progression of the disease.

Key words: type 2 diabetes mellitus, chronic periodontitis, TLR4/MyD88 signaling pathway, inflammatory response