本文選題：牽引 + 顳下頜關(guān)節(jié)　； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：滑膜是顳下頜關(guān)節(jié)囊內(nèi)軟組織的重要組成成分,在維持關(guān)節(jié)的各種功能方面有重要作用。當(dāng)有外界應(yīng)力作用時(shí),應(yīng)力使口頜系統(tǒng)肌鏈的穩(wěn)定狀態(tài)發(fā)生改變,引起顳下頜關(guān)節(jié)周圍肌肉的不平衡,使滑膜細(xì)胞在接受外界刺激信號后,直接或間接產(chǎn)生一些細(xì)胞因子,這些因子會引起自身和關(guān)節(jié)其他組織的適應(yīng)、改建和破壞。IL-1β和VEGF是滑膜組織中常見的細(xì)胞因子,其超生理量的表達(dá)會介導(dǎo)一系列的化學(xué)反應(yīng),引起相應(yīng)靶細(xì)胞的免疫反應(yīng)。IL-1β是重要的促炎細(xì)胞因子之一,可直接和細(xì)胞膜上的受體結(jié)合,刺激各種膠原酶的生成,產(chǎn)生局部破壞作用,加重局部炎癥反應(yīng);也可以通過誘導(dǎo)其他細(xì)胞因子的生成間接地參與關(guān)節(jié)的破壞機(jī)制。VEGF屬于血小板生長因子家族,能特異性作用于血管內(nèi)皮細(xì)胞,促使內(nèi)皮細(xì)胞游走、增殖,在炎癥部位形成新的血管,維持關(guān)節(jié)的炎癥狀態(tài),使炎癥部位發(fā)生增生、充血;也可以誘導(dǎo)和活化各種酶,改變血管通透性,促進(jìn)多種炎癥因子的釋放等。目的:單側(cè)Ⅱ類牽引改變了口頜系統(tǒng)肌鏈的穩(wěn)定狀態(tài),引起顳下頜關(guān)節(jié)及其周圍組織發(fā)生改變,通過觀察和分析滑膜的組織學(xué)改變及IL-1β、VEGF表達(dá)的改變,來探討單側(cè)Ⅱ類牽引對成年大鼠牽引側(cè)顳下頜關(guān)節(jié)滑膜的影響,進(jìn)而為臨床應(yīng)用提供部分參考。方法:180只8周齡的SD(Sprague-Dawley)雄性大鼠,隨機(jī)分為三組:實(shí)驗(yàn)組(A組),假手術(shù)組(B組),空白組(C組),每組60只。A組,在大鼠的右下第一磨牙和右上切牙之間固定Ni-Ti拉簧,加力20ɡ,建立單側(cè)Ⅱ類牽引模型;B組,同A組固定拉簧,功能位加力0ɡ;C組,不固定拉簧。每組再按時(shí)間點(diǎn)(1d、3d、7d、14d、21d、28d)隨機(jī)分為6個(gè)亞組,每亞組10只。按各亞組的時(shí)間點(diǎn)處死各組大鼠,取其右側(cè)顳下頜關(guān)節(jié)雙板區(qū)的滑膜組織進(jìn)行HE、免疫組織化學(xué)染色,觀察滑膜的組織學(xué)變化,檢測IL-1β、VEGF的表達(dá)。結(jié)果:A組的病理分值和B組、C組比較有統(tǒng)計(jì)學(xué)意義(P0.001);A組的IL-1β、VEGF平均光密度值和B組、C組比較有統(tǒng)計(jì)學(xué)意義(P0.001)。病理分值與IL-1β、VEGF的MOD表達(dá)之間有顯著正相關(guān)性(r1=0.912,r2=0.930;P0.001)。結(jié)論:單側(cè)Ⅱ類牽引可引起牽引側(cè)顳下頜關(guān)節(jié)滑膜組織發(fā)生組織學(xué)改變,這種改變與滑膜組織IL-1β、VEGF的表達(dá)有正相關(guān)性。
[Abstract]:Synovium is an important component of soft tissue in temporomandibular joint capsule and plays an important role in maintaining joint function. When there is external stress, the stress changes the stable state of the muscle chain of the oral and mandibular system, causes the imbalance of the muscles around the temporomandibular joint, and makes the synovial cells produce some cytokines directly or indirectly after receiving the external stimulation signal. These factors cause adaptation to themselves and other articular tissues. Remodeling and destroying. IL-1 尾 and VEGF are common cytokines in synovial tissue, and their superphysiological expression mediates a series of chemical reactions. IL-1 尾 is one of the important pro-inflammatory cytokines, which can directly bind to the receptors on the cell membrane, stimulate the production of various collagenase, produce local destruction and aggravate the local inflammatory reaction. VEGF belongs to the platelet growth factor family, which can specifically act on vascular endothelial cells, promote endothelial cell migration and proliferation, also can indirectly participate in the destruction mechanism of joint by inducing the formation of other cytokines. New blood vessels are formed in the inflammatory site to maintain the inflammatory state of the joint and make the inflammatory site proliferate and hyperemia. It can also induce and activate various enzymes change vascular permeability and promote the release of a variety of inflammatory factors. Objective: unilateral class 鈪，

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