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一项关于幼年特发性关节炎患者长期颞下颌关节退变和活动度受损的可能预测因素的回顾性研究。

A Retrospective Study on Possible Predictive Factors for Long-term Temporomandibular Joint Degeneration and Impaired Mobility in Juvenile Arthritis Patients.

出版信息

J Oral Facial Pain Headache. 2017;31(2):165-171. doi: 10.11607/ofph.1656.

DOI:10.11607/ofph.1656
PMID:28437514
Abstract

AIMS

To determine possible predictive factors for long-term temporomandibular joint (TMJ) degeneration and dysfunction in juvenile idiopathic arthritis (JIA) patients.

METHODS

A total of 94 patients (77% female) who had received a JIA diagnosis in an outpatient rheumatology clinic from 1993 to 1994 at a mean ± standard deviation age of 8.3 ± 4.53 years were included in the study. At inclusion, TMJ status regarding condylar degeneration was assessed orthopantomographically and given a Rohlin and Petersson score of 0 or ≥ 1. The maximal mouth opening (MMO) was also measured. Data on possible predictors were gathered retrospectively from the consultation at intake: gender, age at JIA onset, JIA subtype, physical limitations (ie, a Steinbrocker classification score of 0 or ≥ 1), human leukocyte antigen-B27, and antinuclear and rheumatoid factors. Disease duration and medication type were also considered. Associations between all of these factors and long-term condylar degeneration and MMO were assessed by using single and multiple regression analyses.

RESULTS

Long-term TMJ degeneration and smaller MMO were both associated with younger age at JIA onset (P = .01; P = .03) and longer disease duration (P = .05; P = .002). Moreover, MMO was negatively associated with physical limitations at intake (P = .04).

CONCLUSION

Within the limitations of this retrospective study design, these results suggest that young JIA patients with early physical limitations and prolonged disease are at risk of long-term TMJ degeneration and impaired mobility.

摘要

目的

确定幼年特发性关节炎(JIA)患者长期颞下颌关节(TMJ)退变和功能障碍的可能预测因素。

方法

本研究共纳入 94 例(77%为女性)患者,他们于 1993 年至 1994 年在一家门诊风湿病诊所被诊断为 JIA,平均年龄为 8.3 ± 4.53 岁。纳入时,通过全景片评估 TMJ 髁突退变情况,并给予 Rohlin 和 Petersson 评分 0 或≥1。还测量了最大张口度(MMO)。从纳入时的就诊中回顾性收集可能的预测因素数据:性别、JIA 发病年龄、JIA 亚型、身体受限(即 Steinbrocker 分类评分 0 或≥1)、人类白细胞抗原-B27 以及抗核和类风湿因子。还考虑了疾病持续时间和药物类型。使用单因素和多因素回归分析评估所有这些因素与长期髁突退变和 MMO 的关系。

结果

长期 TMJ 退变和较小的 MMO 均与 JIA 发病年龄较小(P =.01;P =.03)和疾病持续时间较长(P =.05;P =.002)相关。此外,MMO 与纳入时的身体受限呈负相关(P =.04)。

结论

在本回顾性研究设计的限制内,这些结果表明,早期存在身体受限和疾病持续时间较长的年轻 JIA 患者有发生长期 TMJ 退变和活动受限的风险。

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