L-单甲基精氨酸治疗间接性颞下颌关节损伤的作用评价

An experimental study of intra-articular injection of NG-methyl-L-arginine for the treatment of indirect temporomandibular joint trauma in goats

目的:评价一氧化氮合酶抑制剂L-单甲基精氨酸治疗间接性颞下颌关节损伤的效果。方法:用自制撞击装置间接性造成9只山羊双侧颞下颌关节损伤。于损伤后3h、7d、14d、21d用0.7mm×32mm注射针向右侧关节上腔注射L-单甲基精氨酸0.5mL,同时向左侧关节腔内注射生理盐水作为对照,伤后3个月取材。处死动物后,在光镜和扫描电镜下观察颞下颌关节的变化。应用SAS9.0软件包中的GLM模型对治疗侧和对照侧的分数进行统计学处理和评价。结果:光镜下观察,对照组髁突、关节盘、关节窝表现为骨关节病变化,治疗组中则表现出不同程度的改善,组织学得分统计学分析,P<0.05。扫描电镜下观察结果与光镜下符合。结论:L-单甲基精氨酸关节上腔重复注射,可减轻间接性山羊颞下颌关节损伤后的组织损害,阻止颞下颌关节骨关节病的形成和发展。

PURPOSE： To investigate the efficacy of NG-methyl-L-arginine （L-NMMA） for treatment of indirect temporomandibular joint trauma in goats. METHODS： Trauma to TMJ in 9 goats were exerted under an impact to the right and left mandibular angle with self-made device, L-NMMA （0.5mL） were injected into the right TMJs after 3 hours,7 days, 14 days,21 days; the left TMJs were injected with normal saline and used as a control . The goats were killed after 3 months . The TMJs of goats were examined with scanning electron microscopy and light microscopy when sacrificed and scored in a subjective manner following the standard criteria which was a modification of the method by Mankin et al and Yoshimi et al. GLM model of SAS 9.0 software package was used to evaluate the scores of the treatment sides and control sides. RESULTS： Under light microscopy and scanning electron microscopy, the left TMJ tissues showed severe osteoarthrotic changes in the temporal surface,disk and condyle, the right TMJ tissues showed significant improvement （P 0.05）. CONCLUSIONS： Repeated intra-articular injection of L-NMMA may reduce the destruction of indirect trauma on goat TMJs. Supported by Natural Science Foundation of Shandong Province for Young Researchers （Grant No.Q2007C01） and Medical Science and Technology Plan of Shandong Province （Grant No.2005HW053）.