5-HT、NPY与TMD患者关节源性疼痛关系的研究

The association of 5-HT,NPY concentrations in synovial fluid with arthralgia in patients with TMD

目的 探讨TMD患者关节液中5 -HT和NPY的水平与关节源性疼痛的关系。方法 用ELISA法检测TMD患者的1 2 6侧关节和健康志愿者的32侧关节的关节液标本中的5 -HT ,用放射免疫测定法检测关节液标本中NPY的含量。1 2 6侧TMD患者的关节液标本分为疼痛组(n =90 )和无痛组(n =36 ) ;32名正常志愿者的32侧关节液设为对照组(n =32 )。结果 所有标本都检出5 -HT ,无痛组含量为1 78.75 0±6 4 .979ng/ml,疼痛组含量为2 2 3.5 2 2±82 .6 36ng/ml,对照组含量为1 36 .1 2 5±5 5 .0 75ng/ml。统计学检验:疼痛组与无痛组、疼痛组与对照组以及无痛组与对照组间比较均有显著性差异(P <0 .0 5 )。NPY检测结果:疼痛组1 33.5 0 0±4 6 .6 6 4 pg/ml,无痛组99.6 5 6±2 5 .873pg/ml,对照组83.2 86±2 8.397pg/ml。统计学检验:疼痛组与无痛组、疼痛组与对照组以及无痛组与对照组间比较均有显著性差异(P <0 .0 5 )。结论 关节液中5 -HT、NPY的水平,患者组显著高于正常人组,并且在患者中疼痛组又显著高于无痛组,表明患者关节内存在炎症状态,也表明关节疼痛与关节液中5 -HT、NPY的水平增高密切相关。

Objective To investigate the relationship between the concentration of 5-HT,NPY and TMJ pain.Methods Samples from 126TMJs in TMD patients were divided into two groups according to whether patients had pain or not:①painful group(n=90);②painless group(n=36).Samples from 32 TMJs in healthy volunteers served as control group(n=32).Radioimmunoassay was used to examine the concentration of NPY and Enzyme-linked immunosorbent assay was used to measure the concentration of 5-HT in synovial fluid.Results The concentration of 5-HT of painful group ( 223.522± 82.63ng/ml) was significantly higher than that of painless group ( 178.750± 64.979ng/ml) and that of control group ( 136.125± 55.075ng/ml)(P< 0.05).Also the concentration of 5-HT of painless group was significantly higher than that of control group (P< 0.05).The concentration of NPY of painful group( 133.500± 46.664pg/ml)( 68/90)was significantly higher than that of painless group ( 99.656± 25.873pg/ml)( 32/36)and that of control group ( 83.286± 28.397pg/ml)( 21/32)(P< 0.05).There was significant difference between painless group and control group(P< 0.05).Conclusion The levels of NPY and 5-HT in synovial fluid of patients were significantly higher than that of healthy volunteers and,among the patients,there was significant difference between painful group and painless group.This indicates that there exist in flammation in TMJ,and that NPY and 5-HT levels are closely correlated with TMJ pain.