摘要
目的在建立小型猪髁突囊内骨折动物模型的基础上,通过评价曲安奈德局部治疗髁突囊内骨折的疗效,进一步探索创伤性颞下颌关节强直发生的机制。方法小型猪10只,随机分为实验组和对照组,每组5只(10侧颞下颌关节),采用手术方法造成双侧髁突囊内骨折;然后实验组用关节囊内注射曲安奈德治疗,对照组则观察其自然愈合。术后6个月,通过大体标本观察、影像学和组织学检查评价各组颞下颌关节强直的形成;利用免疫组织化学染色、RT-PCR和Western Blot技术检测各组颞下颌关节中血管内皮生长因子(Vascular endothelial growth factor,VEGF)、骨钙素(Osteocalcin,OCN)、骨桥蛋白(Osteopontin,OPN)和骨形态发生蛋白-2(Bone morphogenetic protein 2,BMP2)的mRNA和蛋白表达水平。结果实验组颞下颌关节强直发生率显著低于对照组,实验组颞下颌关节中VEGF、OCN、OPN和BMP2的mRNA和蛋白表达水平明显低于对照组,差异有统计学意义(P<0.01)。结论曲安奈德局部注射于关节腔内可有效预防颞下颌关节强直的发生,抑制新骨过度修复是预防关节强直发生的关键因素。
Objective Based on the establishment of animal model of small porcine condylar sac fracture,evaluating the efficacy of triamcinolone acetonide in the treatment of condylar cyst fracture,to explore the mechanism of traumatic temporo-mandibular joint ankylosis.Methods 10 small pigs were randomly divided into experimental group and control group,5 in each group with 10 lateral temporomandibular joint,and the bilateral condylar sac fracture was caused by operation.The experimental group was treated with intra-articular injection of triamcinolone acetonide and observed the natural healing of control group.6 months after operation,the formation of temporo-mandibular joint ankylosis was evaluated by gross specimen observation,imaging and histological examination,and the mRNA and protein expression levels of the vascular endothelial growth factor(VEGF),osteocalcin(OCN),osteopontin(OPN)and bone morphogenetic protein 2(BMP2)in the Temporo-mandibular joint was detected by immunohistochemical staining,RT-PCR and Western blot technique.Results The incidence of temporo-mandibular joint ankylosis in experimental group was significantly lower than that in control group,and the mRNA,protein levels of VEGF,OCN,OPN and BMP2 in the experimental group were significantly lower than those in the control group,and the difference was statistically significant(P<0.01).Conclusion The partial injection of triamcinolone acetonide in the articular cavity can effectively prevent the occurrence of temporo-mandibular joint ankylosis,and inhibiting the new bone repair is the key factor to prevent the occurrence of ankylosis.
作者
李庆华
郭骏
Li Qinghua;Guo Jun(Affiliated Hospital of Panzhihua University,Panzhihua,Sichuan 617000;Sichuan Academy of Medical Sciences·Sichuan Province People′s Hospital,Chengdu,Sichuan 610072,China)
出处
《四川医学》
CAS
2018年第6期610-615,共6页
Sichuan Medical Journal
关键词
颞下颌关节
关节强直
囊内骨折
曲安奈德
temporo-mandibular joint
ankylosis
intracapsular condylar fracture
triamcinolone acetonide
