髁状突髓腔信号异常与关节液TNFα、IL-1β含量关系的研究

Relationship between condylar marrow signal abnormalities and the levels of TNFα and IL-1β in synovial fluid

目的 :探讨核磁共振 (MRI)图像上髁状突髓腔信号异常与TNFα、IL -1β含量的关系。 方法 :对 40例单侧TMJ疼痛患者 ,利用MRI进行闭口斜矢状位T1W和T2 W扫描 ,将T1W和T2 W成像相结合诊断水肿、硬化及混合型髓腔信号异常 ,同时利用T1W成像判定是否伴有骨关节炎 (OA )。在关节上腔冲洗治疗时收集关节液标本 ,采用双抗体夹心酶联免疫法 (ABC -ELASA)检测其关节液标本中TNFα、IL -1β的含量。 结果 :40侧疼痛关节中MRI上表现为髁状突髓腔信号异常的关节 11侧 ,均为水肿型 ,4例伴有OA。髓腔信号异常的关节液中IL -1β、TNFα含量较髓腔信号正常的关节液高 ,经统计学检验两者无显著性差异 ,但髓腔信号异常的关节液中TNFα、IL -1β的检出率显著高于髓腔信号正常的关节。 结论 :髁状突髓腔信号异常的形成可能有IL -1β、TNFα的参与。

Objective:To investigate the relationship between condylar marrow signal abnormalities and the levels of TNFα and IL-1β in synovial fluid of TMD patients. Method:Oblique sagittal T 1 and T 2 Weighted MR imaging at closed mouth were obtained from 40 TMD patients who complained of unilateral TMJ pain. Condylar marrow signal abnormalities were reviewed and classified into bone marrow edema, sclerosis and, combined edema and sclerosis pattern. Osteoarthrosis(OA) was diagnosed according to T 1 weighted MR imaging. Synovial fluid samples were obtained before joint lavage. Enzyme-linked immunosorbent assay was used to measure the concentration of TNFα and IL-1β in synovial fluid. Result: 11/40 joints expressed condylar marrow signal abnormalities in which all showed edema pattern and 4 joints had OA. The levels of TNFα?IL-1β in joints with condylar marrow signal abnormalities were higher than that in joints with normal condylar marrow signal and, although statistical analysis showed no significant difference between them, the detectable rate of TNFα and IL-1β in joints with condylar marrow signal abnormalities were significantly higher than that in joints without. Conclusion: TNFα and IL-1β in synovial fluid is probably involved in the development of condylar marrow abnormalities.