本文選題：髁突軟骨　切入點(diǎn)：雌激素　出處：《安徽醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的特發(fā)性髁突吸收(idiopathic condylar resorption,ICR),又稱原發(fā)性性髁突吸收,臨床上較少見(jiàn),主要涉及顳下頜關(guān)節(jié)(temporomandibular joint,TMJ)大小和形態(tài)的改變,以單側(cè)或雙側(cè)下頜支高度降低,骨質(zhì)吸收,下頜后縮,二類錯(cuò)牙合,小下頜面容改變?yōu)樘卣�。ICR好發(fā)生于年輕女性,病因及發(fā)病機(jī)制尚不明確,關(guān)于雌激素及其受體與ICR關(guān)系的相關(guān)研究已發(fā)現(xiàn),人和動(dòng)物的顳下頜關(guān)節(jié)均存在雌激素受體(estrogen receptor,ER),表明顳下頜關(guān)節(jié)為雌激素的靶器官,本課題組前期研究證實(shí),灌胃避孕藥和制造大鼠卵巢早衰模型均可以誘導(dǎo)大鼠血清雌激素降低,并干擾髁突軟骨成骨,誘導(dǎo)髁突出現(xiàn)一定的退行性改變。故推測(cè)血清雌激素的變化可能通過(guò)ER途徑影響并誘導(dǎo)髁突退變吸收。本研究旨在討論血清雌激素改變對(duì)大鼠髁突軟骨形態(tài)學(xué)改變及α型雌激素受體(Estrogen receptor alpha,ERα)和β型雌激素受體(Estrogen receptor beta,ERβ)表達(dá)的影響,探討雌激素改變?cè)谔匕l(fā)性髁突吸收過(guò)程中可能的作用及影響,以期為ICR在臨床上的治療和預(yù)防提供實(shí)驗(yàn)基礎(chǔ)及指導(dǎo)。方法將40只6周齡健康未孕雌性SD大鼠隨機(jī)平均分為對(duì)照組、避孕藥組、避孕藥+鹽水組和避孕藥+雌二醇組。通過(guò)灌胃避孕藥(去氧孕烯炔雌醇片)和戊酸雌二醇片2種方法分別建立大鼠血清雌激素降低和升高模型。實(shí)驗(yàn)前和第12周、16周分別檢測(cè)血清雌二醇濃度,實(shí)驗(yàn)結(jié)束后處死大鼠,取大鼠髁突軟骨應(yīng)用免疫組織化學(xué)法檢測(cè)ERα、ERβ,蘇木精伊紅(Hematoxylin Eosin,HE)染色法觀察大鼠髁突形態(tài)學(xué)改變。采用SPSS11.0軟件包對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果1.血清雌二醇濃度檢測(cè)結(jié)果顯示:第12周時(shí),與對(duì)照組相比,各組血清雌激素濃度均顯著降低(P0.05);第16周時(shí),與避孕藥+鹽水組相比,避孕藥+雌二醇組血清雌二醇濃度顯著上升(P0.05)。2.免疫組化結(jié)果顯示:各種大鼠髁突軟骨中ERα和ERβ均有表達(dá),均主要分布在肥大軟骨層。與對(duì)照組相比,ERα、ERβ表達(dá)均顯著降低(P0.05);與避孕藥+鹽水組相比,避孕藥+雌二醇組ERα表達(dá)升高(P0.05),ERβ表達(dá)無(wú)明顯改變(P0.05)。3.HE染色結(jié)果顯示:與對(duì)照組相比,避孕藥組大鼠髁突軟骨發(fā)生退行性改變;與避孕藥+鹽水組相比,避孕藥+雌二醇組退變的髁突軟骨出現(xiàn)修復(fù)改變。結(jié)論1.雌激素濃度降低可減少大鼠髁突軟骨部位ERα、ERβ表達(dá),調(diào)節(jié)和介導(dǎo)髁突軟骨退變及軟骨下骨病理改建過(guò)程,最終導(dǎo)致髁突軟骨退行性變。2.外源性戊酸雌二醇的使用,可改善大鼠低雌激素水平,增加ERα表達(dá),并可能通過(guò)ER途徑一定程度上緩解和修復(fù)髁突軟骨退行性變過(guò)程。
[Abstract]:Objective idiopathic condylar resorption-idiopathic condylar resorption-idiopathic condylar absorption, also known as primary condylar resorption, is rarely seen in clinic. It mainly involves the changes of the size and shape of temporomandibular joint TMJ, with the height of unilateral or bilateral mandibular branches decreasing, bone resorption and mandibular retraction.Second class malocclusion, mandibular facial features. ICR-prone to occur in young women, the etiology and pathogenesis is not clear, the relationship between estrogen and its receptor and ICR has been found.Estrogen receptor estrogen receptor ERA exists in human and animal temporomandibular joint, indicating that temporomandibular joint is the target organ of estrogen.The oral contraceptive and the model of premature ovarian failure could induce the decrease of serum estrogen, interfere with the osteogenesis of condylar cartilage and induce some degenerative changes of the condylar process.It is suggested that the changes of serum estrogen may be affected by ER pathway and induce condylar degeneration absorption.The aim of this study was to investigate the effects of serum estrogen on the morphological changes of condylar cartilage and the expression of ER 偽 and Estrogen receptor beta in rat condylar cartilage.To explore the possible effect of estrogen on idiopathic condylar resorption in order to provide experimental basis and guidance for clinical treatment and prevention of ICR.Methods 40 healthy female SD rats aged 6 weeks without pregnancy were randomly divided into control group, contraceptive group, contraceptive saline group and contraceptive estradiol group.The serum estradiol (estradiol valerate) and estradiol valerate (estradiol valerate) were administered intragastrically to establish the model of serum estrogen reduction and elevation in rats.Serum estradiol concentrations were measured before and 16 weeks after the experiment. The condylar cartilage of the rats was killed. The condylar cartilage of the rats was detected by immunohistochemical method for ER 偽 -ER 尾 and Hematoxylin EosinHEH staining for the morphological changes of the condylar process of the rats.The data were analyzed by SPSS11.0 software package.Result 1.The results of serum estradiol concentration test showed that at the 12th week, compared with the control group, the serum estradiol concentration in each group was significantly lower than that in the control group, and at the 16th week, the serum estradiol concentration in the contraceptive estradiol group was significantly higher than that in the control group, and at the 16th week, the serum estradiol concentration in the contraceptive estradiol group was significantly higher than that in the control group.The results of immunohistochemistry showed that ER 偽 and ER 尾 were all expressed in the condylar cartilage of rats, and they were mainly distributed in the hypertrophic chondrocytes.The degenerative changes of condylar cartilage were observed in the contraceptive group and the restoration of the degenerative condylar cartilage was observed in the estradiol group as compared with the saline group.Conclusion 1.The decrease of estrogen concentration can reduce the expression of ER 偽 and ER 尾 in rat condylar cartilage, regulate and mediate the process of condylar cartilage degeneration and subchondral bone pathological remodeling, and eventually lead to condylar cartilage degeneration.The use of exogenous estradiol valerate could improve the low estrogen level and increase the expression of ER 偽 in rats, and could alleviate and repair the degenerative process of condylar cartilage to some extent through ER pathway.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R782

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