锥体束CT联合MMP-2对义齿修复患者颞下颌关节骨关节病的诊断价值  

Diagnostic value of cone beam CT combined with MMP-2 in temporomandibular joint osteoarthropathy in patients with denture restoration

作　　者：宿静 杜艳锋 董文博 SU Jing;DU Yanfeng;DONG Wenbo(Department of Endodontics,Handan Stomatological Hospital,Handan,Hebei 056000,China;Department of Prosthetics,Handan Stomatological Hospital,Handan,Hebei 056000,China)

机构地区：[1]河北省邯郸市口腔医院牙体牙髓科,河北邯郸056000 [2]河北省邯郸市口腔医院修复科,河北邯郸056000

出　　处：《检验医学与临床》2024年第20期3059-3062,3067,共5页Laboratory Medicine and Clinic

基　　金：河北省医学科学研究重点课题计划项目(20191818)。

摘　　要：目的分析锥体束CT联合颞下颌关节滑液中基质金属蛋白酶2(MMP-2)水平检测对义齿修复患者颞下颌关节骨关节病的诊断价值。方法选取2019年2月至2021年2月在该院经固定义齿修复后出现颞下颌关节骨关节病的患者51例作为研究组。另选取同期55例固定义齿修复后无颞下颌关节骨关节病者作为对照组。对两组研究对象颞下颌关节进行锥体束CT检测,判定锥体束CT检测与临床诊断的一致性,并测定研究对象髁突高;收集研究对象颞下颌关节滑液检测MMP-2水平,采用受试者工作特征(ROC)曲线分析颌关节滑液MMP-2水平对义齿修复后颞下颌关节骨关节病的诊断价值;分析锥体束CT、MMP-2联合检测诊断义齿修复后颞下颌关节骨关节病与临床诊断的一致性。结果锥形束CT检测出颞下颌关节骨关节病者53例,未患颞下颌关节骨关节病者53例,其中假阳性11例,假阴性9例。锥形束CT检测与诊断一致性较好(Kappa=0.623,P<0.05)。与对照组比较,研究组颞下颌关节髁突高降低[(13.26±2.35)μg/L vs.(16.33±2.87)μg/L],差异有统计学意义(P<0.05)。与对照组比较,研究组颞下颌关节滑液中MMP-2水平升高[(38.57±6.22)μg/L vs.(21.53±4.03)μg/L],差异有统计学意义(P<0.05)。ROC曲线分析结果显示,颞下颌关节滑液MMP-2水平诊断颞下颌关节骨关节病的曲线下面积为0.791,灵敏度为74.5%,特异度为78.2%,最佳截断值为29.073μg/L。颞下颌关节滑液MMP-2水平诊断颞下颌关节骨关节病50例,未发生颞下颌关节骨关节病56例,与临床诊断一致性较好(Kappa=0.527,P<0.05),诊断灵敏度、特异度分别为74.5%、78.2%。二者联合检测义齿修复患者发生颞下颌关节骨关节病63例,未发生颞下颌关节骨关节43病例,与临床诊断一致性较好(Kappa=0.738,P<0.05),诊断灵敏度、特异度分别为98.0%、76.4%。与锥体束CT、MMP-2相比,联合检测诊断灵敏度更高,差异有统计学意义(P<0.05)。结论Objective To analyze the diagnostic value of cone beam CT combined with detection of matrix metalloproteinase-2(MMP-2)in temporomandibular joint synovial fluid for temporomandibular joint osteoarthrosis in patients with denture restoration.Methods A total of 51 patients with temporomandibular joint osteoarthropathy after fixed denture restoration in this hospital from February 2019 to February 2021 were selected as the study group.A total of 55 patients without temporomandibular joint osteoarthrosis after fixed denture restoration were selected as the control group.The cone beam CT examination of temporomandibular joint was performed in the two groups to determine the consistency between cone beam CT examination and clinical diagnosis,and the condylar height was measured.The level of MMP-2 in synovial fluid was detected.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of MMP-2 level in synovial fluid for temporomandibular joint osteoarthrosis after denture restoration.To analyze the consistency between the combined detection of cone beam CT and MMP-2 and clinical diagnosis of temporomandibular joint osteoarthrosis after denture restoration.Results Cone beam CT detected 53 cases of temporomandibular joint osteoarthrosis and 53 cases without temporomandibular joint osteoarthrosis,including 11 false positive cases and 9 false negative cases.The consistency between cone beam CT detection and diagnosis was good(Kappa=0.623,P<0.05).Compared with the control group,the condylar height of temporomandibular joint in the study group decreased[(13.26±2.35)μg/L vs.(16.33±2.87)μg/L],and the difference was statistically significant(P<0.05).Compared with the control group,the level of MMP-2 in the synovial fluid of the temporomandibular joint in the study group was increased[(38.57±6.22)μg/L vs.(21.53±4.03)μg/L],and the difference was statistically significant(P<0.05).ROC curve analysis results showed that the area under the curve of MMP-2 level in synovial fluid for the diagnosis

关 键 词：锥体束CT 颞下颌关节滑液 基质金属蛋白酶2 义齿修复 颞下颌关节骨关节病 

分 类 号：R782.6[医药卫生—口腔医学] R445.2[医药卫生—临床医学]