颞颌关节内紊乱症治疗前后关节滑液中PGE2的水平变化

目的：通过检测关节内紊乱症（ＴＭＪＩＤ）患者关节滑液中ＰＧＥ２的水平变化，研究ＰＧＥ２与ＴＭＪＩＤ的关系并探讨皮质激素药物关节腔内注射治疗的作用机理和利弊。方法：对１６例疼痛性ＴＭＪＩＤ患者关节腔内醋酸强的松龙注射治疗，采用放免法检测治疗前后关节滑液中ＰＧＥ２的含量并作对比研究。结果：注药后３周和９周的滑液中ＰＧＥ２含量较注药前有显著下降，有高度统计学差异（Ｐ＜０．０１），同时关节疼痛症状明显改善。注药后９周与３周相比有部分患者的疼痛症状有复发趋势，同时伴有ＰＧＥ２含量的回升。结论：ＰＧＥ２水平变化与关节内紊乱症的疼痛症状密切相关，ＰＧＥ２可作为判定ＴＭＪＩＤ滑膜炎的一个重要指标。皮质激素类药物关节腔内注射对缓解疼痛是一种有效但可能是短期的保守疗法

The change of PGE 2 level in synovial fluid of TMJID patients following intra articular prednisone acetate injection

Objective: To observe the change of PGE 2 level in synovial fluid(SF) of TMJID patients and to evaluate the effects of intra articular prednisone acetate injection.Methods:16 cases of painful TMJID patients were treated with intra articular injection of prednisone acetate. The concentrations of PGE 2 in SF before and after the injection were measured using RIA.Results:The levels of PGE 2 in SF before and 3 weeks after intra articular injection of prednisone acetate were 611.1 ng/L and 221.9 ng/L respectively ( P < 0.01 ), accompanying evident relief of TMJ pain. However, 9 weeks after the injection, there was a tendency of recurrance of the pain in TMJ and elevation of PGE 2 concentration in 5 cases( P < 0.01 ).Conculusion:PGE 2 is closely related to the degree of pain in TMJID patients. PGE 2 level in SF can be regarded as an index of severity of secondary synovitis in TMJID. Prednisone acetate injection is effective in controling inflammation and alleviating the symptoms, but its effect may be of short term.