颞下颌关节紊乱病关节液中尿纤溶酶原激活物及其受体的表达

目的 检测颞下颌关节(TMJ)关节液中尿纤溶酶原激活物(urokinase-type plasminogen activator,uPA)及受体(urokinase-type plasminogen activator receptor,uPAR)的分泌量,探讨TMJ液中uPA及uPAR与颞下颌关节紊乱病(TMD)的关系.方法 采用酶联免疫吸附实验法检测56例TMD患者的64侧关节和10名健康志愿者的16侧关节的关节液标本中的uPA及uPAR的量.将符合纳入标准的48侧TMD患者的关节液标本根据临床诊断分为关节炎性组(A组)、结构紊乱组(B组)、骨关节病组(C组),每组16侧;10名健康志愿者的16侧关节液设为对照组(D组).结果 TMD中A组、B组、C组、D组uPA的检出量分别为(51.200±8.786)ng/L、(53.667±11.894)ng/L、(81.278±25.828)ng/L、(17.960±9.859)ng/L;uPAR检出量分别为(5.840±0.179)ng/L、(6.168±1.465)ng/L、(2.416±0.525)ng/L、(2.416±0.525)ng/L.uPA和uPAR表达量均高于健康对照组(P＜0.05),C组uPA和uPAR表达量高于A组及B组(P＜0.05),但A组与B组差异无统计学意义(P＞0.05).结论 TMJ内过度分泌的uPA和uPAR可能参与了TMD关节组织的病理破坏过程;关节液中uPA和uPAR的水平可部分反映TMD病变的程度,可作为反映TMD关节损害和代谢的客观生化分子标志.

Expression of urokinase-type plasminogen activator and urokinase-type plasminogen activator receptor in synovial fluid of patients with temporomandibular disorders

OBJECTIVE: To investigate the level of urokinase-type plasminogen activator (uPA) and urokinase-type plasminogen activator receptor (uPAR) in synovial fluid of patients with temporomandibular disorders and to analyze their relation with temporomandibular disorders (TMD). METHODS: Synovial fluid was obtained from 64 sides of 56 TMD patients and from 16 sides of 10 asymptomatic healthy volunteers (control). The concentrations of uPA and uPAR in the synovial fluid were measured by ELISA. Forty-eight sides of TMD were divided into 3 groups: arthrosis, structure disorder and osteoarthrosis, each including 16 sides. RESULTS: The levels of uPA and uPAR were significantly higher in the synovial fluid of TMD patients than that in the control group (P < 0.05), and the level of uPA and uPAR in osteoarthrosis group was significantly higher than that in arthrosis and structure disorder group (P < 0.05). However, there was no difference in expression of uPA and uPAR between arthrosis and structure disorder groups (P > 0.05). CONCLUSIONS: uPA and uPAR in the synovial fluid may play a role in the pathogenesis of TMD, and the lever of uPA and uPAR in synovial fluid of TMD could be used as a biochemical markers to reflect pathological degree of TMD.