检测关节液MMP-3对颞下颌关节紊乱病诊断的意义

Value of Joint Fluid MMP-3 in Diagnosis of TMD

目的:探讨颞下颌关节紊乱病(TMD)患者关节液中基质金属蛋白酶-3(MMP-3)与关节病变程度的关系。方法:留取115例TMD患者符合标准的126侧关节和健康志愿者32侧关节关节液标本。患者标本依据临床和TM J影像学检查,分为①关节炎症性疾病(C/S)组(n=24);②结构紊乱(ID)组(n=58);③骨关节病(OA)组(n=44);④健康志愿者关节液设为对照组(n=32)。用ELISA法检测关节液标本中MMP-3含量。结果:OA组MMP-3含量为(74.677±46.910)ng/m l(32/44),ID组为(49.086±22.298)ng/m l(20/58),C/S组为(32.609±9.470)ng/m l(7/24),对照组含量为(23.663±8.767)ng/m l(14/32)。OA组、ID组与C/S组及对照组比较有显著差异(P<0.05);ID组、C/S组与对照组比较亦有显著差异(P<0.05)。结论:MMP-3直接参与了TM J关节组织的病理破坏过程;关节液中MMP-3的水平反映了TMD病变的严重程度;关节液中的MMP-3可以作为一个反映TMD关节损害和代谢的重要分子标志。

Objective ：To investigate the relationship between the concentration of matrix metalloproteinase-3 （MMP-3） in synovial fluid and the degree of tissue lesion in TMJs from patients with TMD. Methods：Samples from 126 TMJs in TMD patients were divided into three groups according to clinical examination and imaging findings ： ① Capsulitis/Synovitis （C/S） group （ n=24 ） ; ②Internal derangement （ID） group （n = 58 ） ; ③ Osteoarthritis （OA） group （n=44）. ④Samples from asymptomatic volunteers served as control group （n=32）. The concentration of MMP-3 in TMJ synovial fluid was measured using Enzyme-linked -immunosorbent-assay （ELISA）. ResuIts： The level of MMP-3 in OA group （74. 677±46. 910）ng/ml, was significantly higher than that in ID group （49. 086±22. 298 ）ng/ml, C/S group （32. 609±9. 470）ng/ml and control group （23.663±8.767 ）ng/ml （ P 〈 0.05 ）. Both the levels of MMP-3 in ID group and C/S group were significantly higher than that in control group （P〈0.05 ）. ConcIusion： MMP-3 was involved in the pathogenesis of TMD. The level of MMP-3 in synovial fluid could reflect the degree of lesion of TMJs.