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性。材料与方法：1997年10月至1998年8月，对24例颞下颌关节紊乱病患者（平均年龄42.1*20.1岁，年龄14 ~ 86岁）进行了关节穿刺术和透明质酸钠注射术。于关节穿刺时抽取关节液，用ICTP放射免疫法测定关节液中ICTP浓度。测试结果：术前平均最大切缘开度为33.5 ± 11.1mm，术后1个月切缘开度增加43.0 ± 6.2mm，疼痛消失或减轻。关节液ICTP浓度GA组（2.6 × 2.8 ng/ml）与ID组（2.4 × 2.2 ng/ml）比较差异无统计学意义。然而，不良反应者（术后约1个月时MIO<40.0 mm）的ICTP平均浓度（3.8*3.3 ng/ml）高于良好反应者（MIO* 40.0 mm）的ICTP平均浓度（2.2*2.1 ng/ml）。结论：本研究结果表明，ICTP浓度可能是一个有效的预测关节穿刺术的结果。

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.