颞下颌关节关节腔内糖皮质激素注射对关节局部与全身影响的实验学研究  

Experimental Study of the Effect of Intra-injection of Glucocorticoids in Temporomandibular Joints on the Local Condylar tissue and Systematic Condition of the Body.

作　　者：梅林[1] 刘勇刚[1] 冯怀玉[1] 

机构地区：[1]黄石市中心医院口腔科,湖北黄石435000

出　　处：《口腔医学研究》2003年第1期56-59,共4页Journal of Oral Science Research

摘　　要：目的 :研究糖皮质激素颞下颌关节腔内注射对髁突组织的局部影响和对全身代谢状况的影响。方法 :采用不同剂量及注射频率糖皮质激素行兔颞下颌关节腔内注射 ,分别对进行髁突组织及实验动物血生化指标检测。结果 :糖皮质激素对关节软骨、软骨下骨组织和滑膜组织产生不同程度的损伤 ,损伤程度与注射次数、注射剂量有直接关系 ,注射 1～ 2次者 ,基本上不会造成严重的损害。注射 4次者 ,可造成纤维软骨明显损害 ,并产生下方骨组织的严重破坏和丧失 ,以及关节滑膜化生。血生化检测发现 ,出现了明显的低磷、高钙症状 ,随即伴发高磷、低钙症 ;类风湿因子与C -反应蛋白水平均明显低于正常水平。结论 :高频率、大剂量关节内注射皮质类固醇 ,可造成髁突组织不可复性损伤 ,并可造成类似甲状旁腺功能亢进的结果 。Objective:To study the effect of intra-articular injection of glucocorticoids in temporomandibular joints on the local condylar tissue and the systematic conditions of the body.Methods:Different dosage of corticosteroid (2mg each time or 4mg each time) was adopted to do the intra-articular injection for one to four time in rabbits.The condylar tissue was studied histologically to investigate the effect of hormone therapy on the joints.Meanwhile,the biochemical examination of blood was made to investigate the effect of such therapy on the systematic condition of the bodies.Results:Histological examinations disclosed signs of severe destruction of cartilage and bone.The degree of damage is related to the frequency and dosage of injection.No obvious damage to the joint could be observed after one or two injections.By the fourth intra-articular injection, definite change was noted in the articular cartilage,combined with severe deterioration and loss of the subchondral bone, and the metaplasia of synovium.Biochemical examination of blood indicated that the development of distinct hypophosphatemia,hypercalcemia followed by hyperhosphaturia, and hypocalcicuria.All treated animals showed the obvious decreased level of rheumatoid factor and C-reactive protein than that of the normal control.Conclusions:High dosage and frequency of glucocorticoids in temporomandibular joint could lead to the irreversible damage to the condyles.It may lead to the parathyroid hyperactivity and suppression of systematic immunity.

关 键 词：糖皮质激素 颞下颌关节 病理学 机体代谢 

分 类 号：R782.6[医药卫生—口腔医学]