Comparison between concentration of I type collagen C-terminal telopeptide (ICTP) in the synovial fluid and semi-quantified ^<99m>Tc-MDP accumulation of the temporpmandibular joint in the tempromandibular joint disorders (TMD).

我们研究了颞下颌关节紊乱的关节穿刺术的临床结果与滑液中骨代谢标志物 ICTP（I 型胶原 C 末端端肽）浓度之间的关系。本研究的目的是评估 ICTP 对关节穿刺术结果的预测能力。材料与方法：1997年10月至1998年8月期间，24例颞下颌关节紊乱患者（平均年龄42.1*20.1岁，年龄范围14至86岁）接受关节穿刺术和透明质酸钠注射颞下颌关节治疗。其中14例患者中16个颞下颌关节临床诊断为内部紊乱（ID），10个颞下颌关节紊乱10 名患者被诊断为骨关节病 (QA)。关节穿刺术时从26个关节获取滑液。使用ICTP放射免疫测定法测量ICTP浓度。结果：术前平均最大切牙开口 (MIG) 为 33.5 ± 11.1 毫米。术后约1个月，MIG增大（43.0×6.2mm），所有患者疼痛消失或减轻。 GA（2.6*2.8 ng/ml）和ID（2.42.2 ng/ml）患者滑液ICTP浓度无显着差异。然而，不良反应者(手术后约1个月时MIO<40.Omm)的ICTP平均浓度(3.8*3.3ng/ml)高于良好反应者(MIO*40.0mm)的(2.2*2.1ng/ml)。结论：本研究结果表明 ICTP 浓度可能是关节穿刺术结果的有效预测因子。

We investigated the relationship between clinical outcome of arthrocentesis in temporomandibular joint >sorders and the concentration of the bone metabolic marker, ICTP (type I collagen C-terminal telopeptide), in the synovial fluid. The purpose of this study is to evaluate the predictability of ICTP for outcome of arthrocentesis. Materials and Methods : Twenty-four patients with TMJ disorders (mean age ; 42.1*20.1 years, range in age from 14 to 86) undergoing arthrocentesis and sodium hyaluronate injection of TMJs were enrolled in this study between October 1997 and August 1998.Sixteen TMJs of 14 patients were clinically diagnosed internal derangements (ID) and 10 TMJs of 10 patients were diagnosed osteoarthrosis (QA). Synovial fluid was obtain from 26 joints at the time of arthrocentesis.The concentration of ICTP was measured using ICTP radio immunoassay. Result : The mean preoperative maximum incisal opening (MIG) was 33.5 11.1 mm. About one month after the procedure, MIG increased (43.0 *6.2mm), and pain disappeared or decreased in all patients. There was no significant difference in ICTP concentration of the synovial fluid between patients with GA (2.6*2.8 ng/ml) and ID (2.42.2 ng/ml). However, the mean concentration of ICTP from poor responders (MIO<40.Omm at the time about one month after the procedure) was higher (3.8*3.3 ng/ml) than those (2.2*2.1 ng/ml) of good responders (MIO*4O.O mm). Conclusion : The results of this study indicate that ICTP concentration may be an efficient predictor for the outcome of arthrocentesis.