地塞米松在创伤性颞下颌关节强直中的作用机制研究  

Study on the Mechanism of Dexamethasone in Traumatic Temporomandibular Joint Ankylosis

作　　者：张清华 郭骏[2] 高明玉 李明芳 费伟 Zhang Qinghua;Guo Jun;Gao Mingyu;Li Mingfang;Fei Wei(Southwest Medical University,Luzhou 646000,China;Sichuan Academy of Medical Sciences•Sichuan Provincial People's Hospital,Chengdu 610072,China;School of Stomatology,North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]西南医科大学,泸州646000 [2]四川省医学科学院·四川省人民医院,成都610072 [3]川北医学院口腔医学院,南充637000

出　　处：《成都医学院学报》2023年第2期149-153,共5页Journal of Chengdu Medical College

基　　金：四川省卫生和计划生育委员会普及应用项目(No:18PJ096)。

摘　　要：目的 通过建立小型猪髁突囊内骨折(ICF)动物模型,探讨地塞米松在预防颞下颌关节强直中的作用。方法 对15只3个月龄健康小型猪行ICF,随机将猪分为3组:自然愈合组、生理盐水组、地塞米松组。通过定量实时聚合酶链反应(RT-PCR)和蛋白质印迹技术检测血管内皮生长因子(VEGF)、骨钙素(OCN)、骨桥蛋白(OPN)、骨形态发生蛋白(BMP2)的mRNA和蛋白表达水平。结果 与自然愈合组和生理盐水组相比,地塞米松组发生关节强直的风险较小(P<0.05)。术后6个月地塞米松组最大颌骨张开度明显高于自然愈合组和生理盐水组(P<0.05)。在大体标本观察、影像学、组织学检查中,自然愈合组比生理盐水组和地塞米松组有更多的病理变化。自然愈合组VEGF、OCN、OPN蛋白及mRNA表达明显高于生理盐水组和地塞米松组(P<0.05)。结论 VEGF、OCN、OPN和BMP2是参与外伤性颞下颌关节强直的重要蛋白。地塞米松通过抑制VEGF、OCN、OPN的表达,从而降低颞下颌关节强直的发生风险。Objective To investigate the role of dexamethasone in the prevention of temporomandibular joint TMJ ankylosis by establishing an animal model of intracapsular condyle fracture ICF in miniature pigs.Methods ICF was performed in 15 healthy 3-month-old miniature pigs,which were randomly divided into 3 groups:natural healing group,saline group and dexamethasone group.The mRNA and protein expression levels of vascular endothelial growth factor(VEGF),osteocalcin(OCN),osteopontin(OPN),and bone morphogenetic protein-2(BMP2)were measured by realtime polymerase chain reaction(RT-PCR)and Western blotting.Results The risk of joint ankylosis was lower in dexamethasone group than that in natural healing group and saline group(P<0.05).At 6 months after operation,the maximum jaw opening in dexamethasone group was significantly higher than that in natural healing group and saline group(P<0.05).Gross specimen observation,imaging and histological examination showed that there were more pathological changes in natural healing group than in saline group and dexamethasone group.The protein and mRNA expressions of VEGF,OCN and OPN in natural healing group were significantly higher than those in normal saline group and dexamethasone group(P<0.05).Conclusion VEGF,OCN,OPN and BMP2 are important proteins involved in traumatic TMJ.Dexamethasone may inhibit the expression of VEGF,OCN,and OPN,and thus reduce the occurrence of TMJ.

关 键 词：颞下颌关节强直 关节创伤 糖皮质激素 成骨因子 

分 类 号：R782.6[医药卫生—口腔医学]