颞下颌关节紊乱病关节液雌二醇及骨钙素的检测及其临床意义

目的 检测颞下凳关节滑液中骨钙素及雌二醇半探讨其在颞下颌关节紊乱病中的意义。方法 采用放射免疫分析法分别对31侧及42侧颞下颌关节紊乱病患者关系液中骨钙素及雌二醇进行了测定，并分析了滑液骨钙素及雌二醇水平与TMD关系。结果 结构紊乱类滑液骨钙素浓度与正常对照组无明显差异（P＞0.05），而OA类滑液骨钙素浓度比正常对照组及结构紊乱类明显增高（P＜0.05）。结论紊乱类与OA类关节液中E2浓度无明显差异，但均比对照组明显高。TMD患者中骨质硬化改变者滑液E2浓度明显高于其它类骨质改变者。结论 雌激素在颞下颌关节紊乱病的发生发展中起一定作用。高浓度滑液E2可能与关工骨质增生硬化相关。颞下颌关节骨关节病与局部同有转换增高及骨代谢异常有关，骨钙素可能是TMD骨改变的标志物之一。

Osteocalcin and estradiolin synovial fluid of the patients with temporomandibular disorders

Objective To determine whether osteocalcin and estrogen existed in synovial fluid and to study the relationship between the synovial osteocalcin and estradiol levels and temporomandibular disorders.Methods Synovial fluid was obtained from 31 temporomandibular joints (TMJs) of the patients with TMD for osteocalcin,and 42 TMJs for estradiol detection respectively.All patients were diagnosed as internal derangement (ID) or osteoarthrosis by raiographs and clinical examination.7 synovial fluid samples of healthy volunteers served as normal control.The concentration of osteocalcin and estradiol in synovial fluid was determined by radioimmunoassay (RIA)..The association of synovial osteocallcin and estradiol levels with TMD and their clinical significances were also discussed.Results Synovial fluid osteocalcin was found in all patients and controls.There was no significant difference in synovial osteocalcin level between ID and normal control (P> 0.05 ),but the concentration of synovial osteocalcin was significant higher in OA than that of the normal control and ID (P< 0.05 ).Synovial fluid E 2 was found in all patients and controls.The concentration of synovial E 2 was significant higher in ID and OA than that of normal control,but there was no significant difference in synovial E 2 level between ID and OA.Synovial E 2 level was much higher in TMJs with osteosclerotic change and no difference between male and female patients with TMD.Conclusion These results suggest that estrogen could be involved in the pathogenesis and development of TMD.High level of synovial estradiol may contribute to osteoselerotic change of TMJs.Meanwhile,TMJOA may relate to local increase of bone turnover and abnormalities of bone metabolism.Quantification of osteocalcin in synovial fluid holds promise as a useful means of assesing the alteration of bone at the molecular level in the patients with TMD.