透明质酸钠和泼尼松龙对兔颞下颌关节软骨损伤治疗效果的研究

The Trauma Treatment Effect of Sodium Hyaluronate and Prednisolone of Articular Cartilage of the Rabbits' Temporomandibular Joints

目的 比较局部应用透明质酸钠和泼尼松龙对兔颞下颌关节软骨损伤的治疗效果。方法 选用成年健康新西兰大白兔27只,随机分成4组。第1组:兔颞下颌关节髁突软骨全层损伤后局部应用泼尼松龙(12.5 mg),10只;第2组:兔颞下颌关节髁突软骨全层损伤后局部应用透明质酸钠(5 mg),10只;第3组:兔颞下颌关节髁突软骨全层损伤手术对照组,5只;第4组:正常对照组,2只。分别于术后1、2、4、8、12周处死,对髁突软骨及其修复组织进行大体形态学及组织学检查。结果 第1、2组实验动物的髁突软骨损伤区为纤维结缔组织增生,术后12周时,损伤区充满致密的纤维结缔组织,胶原纤维排列有序,与关节面平行。修复组织的质量类似,但第2组髁突软骨的退行性改变较第1组明显减轻。结论 泼尼松龙和透明质酸钠都能促进髁突软骨损伤后的修复,在预防颞下颌关节软骨的退行性改变方面,透明质酸钠优于泼尼松龙。

Objective To compare the trauma treatment effects of sodium hyaluronate and prednisolone of articular cartilage of the rabbits' temporomandibular joints. Methods Twenty-seven adult rabbits were divided into sodium hyaluronate-treated group (10 rabbits) , prednisolo-ne-treated group (10 rabbits), postoperative-group(5 rabbits) and normal-group (2 rabbits) randomly.A full-thickness defect without penetrating the subchondral compact bone was made in the condyle of the rabbits, sodium hyaluronate (5 mg) and prednisolone (12.5 mg) were applied locally.Every rabbit was killed 1 week,2 weeks,4 weeks,8 weeks or 12 weeks,respectively, after the operation.The reparative tissue and condylar cartilage were observed morphologically and histologically. Results In the area of the defect of the condylar cartilage was filled with compact fibrous tissue at the end of the 12th week. The collagenous fibres arranged in order and paralleled with the joint surface. The reparative tissue of sodium hyaluronate-treated group was similar to that of prednisolone-treated group. But in the sodium hyaluronate-treated group, the condylar cartilages were less destroyed than in the prednisolone-treated group. Contusions Sodium hyaluronate and prednisolone were able to repair the defect of the TMJ' condylar cartilage. Sodium hyaluronate could obviously reduce the destruction of TMJ' condylar cartilage on rabbits, compared with prednisolone.