摘要：

目的： 探讨颞下颌关节骨关节炎（temporomandibular joint osteoarthritis，TMJOA）患者血清白细胞介素-1β（interleukin-1β，IL-1β）、骨桥蛋白（osteopontin ，OPN）、转化生长因子-β1（transforming growth factor-β1，TGF-β1）与TMJOA病情的关系，并分析IL-1β、OPN、TGF-β1诊断TMJOA的价值。方法： 选择2018年2月—2021年1月我院口腔科收治的101例TMJOA患者（TMJOA组）和92例于门诊体检的志愿者（对照组）。根据视觉模拟评分法（visual analogue scale，VAS）将TMJOA组分为轻度疼痛亚组（3分以下，38例）、中度疼痛亚组（4~6分，40例）及重度疼痛亚组（7分及以上，23例）；根据非辅助下最大开口度（maximal mouth opening，MMO）将TMJOA组分为≤2 cm亚组（34例）、2.1~3.0 cm亚组（42例）及>3.0 cm亚组（25例）。比较不同组间血清IL-1β、OPN、TGF-β1水平的差异。采用Pearson相关性分析法分析血清IL-1β、OPN、TGF-β1水平与VAS评分和MMO之间相关性，采用受试者工作特征（receiver operating characteristic curve，ROC）曲线分析IL-1β、OPN、TGF-β1诊断TMJOA的价值。结果： 与对照组相比，TMJOA组血清IL-1β、OPN及TGF-β1水平更高（t=18.894、19.552、20.405，P<0.05）。重度疼痛亚组血清IL-1β、OPN、TGF-β1水平高于中度疼痛亚组和轻度疼痛亚组（均P<0.05），≤2 cm亚组血清IL-1β、OPN、TGF-β1水平高于2.1~3.0 cm亚组和>3.0 cm亚组（均P<0.05）。IL-1β、OPN、TGF-β与VAS评分呈正相关（r=0.819、0.783、0.816，P<0.05），与MMO呈负相关（r=-0.767、-0.782、-0.805，P<0.05）。IL-1β、OPN、TGF-β诊断TMJOA的曲线下面积（area under curve, AUC）分别为0.691、0.740、0.732。结论： TMJOA 患者血清IL-1β、OPN、TGF-β1水平均升高，IL-1β、OPN、TGF-β1增高与TMJOA疼痛加重及开口受限均有关，可作为诊断TMJOA的辅助指标。

关键词: 颞下颌关节炎, 白细胞介素-1β, 骨桥蛋白, 转化生长因子-β1

Abstract:

Objective: To investigate the relationship between serum detect of interleukin-1β(IL-1β), osteopontin (OPN), transforming growth factor-β1(TGF-β1) and the state of temporomandibular joint osteoarthritis (TMJOA), and to analyze the diagnostic value of IL-1β, OPN, TGF-β1 in TMJOA. Methods: A total of 101 TMJOA patients(TMJOA group) and 92 volunteers (control group) were enrolled in the department of stomatology of our hospital from February 2018 to January 2021. According to scores of visual analogue scale(VAS), Patients in TMJOA group was divided into mild pain subgroup (n=38, below 3 points), moderate pain subgroup(n=40, 4-6 points), and severe pain subgroup (n=23, 7 points and above). Patients were also divided into ≤2 cm subgroup(n=34), 2.1-3.0 cm subgroup (n=42) and >3.0 cm subgroup (n=25) according to the unassisted maximal mouth opening(MMO). The differences in serum levels of IL-1β, OPN and TGF-β1 were compared among different groups. The correlations between IL-1β, OPN, TGF-β1 and VAS score, MMO were analyzed by Pearson correlation analysis respectively. The diagnostic value of IL-1β, OPN, TGF-β1 in TMJOA was analyzed by receiver operating characteristic(ROC) curve. Results: Compared with control group, serum levels of IL-1β, OPN, TGF-β1 in TMJOA group were higher(t=18.894, 19.552, 20.405, P<0.05). Serum levels of IL-1β, OPN, TGF-β1 in severe pain subgroup were higher than those in moderate pain subgroup and mild pain subgroup(both P<0.05). Serum levels of IL-1β, OPN, TGF-β1 in ≤2 cm subgroup were higher than those in 2.1-3.0 cm subgroup and >3.0 cm subgroup(both P<0.05). IL-1β, OPN, TGF-β were positively correlated with VAS score (r=0.819, 0.783, 0.816, all P<0.05), and negatively correlated with MMO (r=-0.767, -0.782, -0.805, all P<0.05). The area under curve (AUC) of IL-1β, OPN and TGF-β 1 in the diagnosis of TMJOA were 0.691, 0.740 and 0.732, respectively. Conclusion: Serum levels of IL-1β, OPN, TGF-β1 are all increased in TMJOA patients, and the increase of IL-1β, OPN, TGF-β1 is associated with exacerbated TMJOA pain and restricted mouth opening, which can be used as auxiliary indicators for the diagnosis of TMJOA.

Key words: temporomandibular joint osteoarthritis, interleukin-1β, osteopontin, transforming growth factor-β1

中图分类号: 

• R782