温度骤降敏感的颞下颌关节紊乱综合征患者的临床特点初步分析

doi:10.7518/hxkq.2025.2024321

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (2): 269-274.doi: 10.7518/hxkq.2025.2024321

温度骤降敏感的颞下颌关节紊乱综合征患者的临床特点初步分析

胡一帆¹^,²(), 马博文², 翟孝庭³, 徐鑫宇², 王一涵⁴, 李鸿波², 胡敏², 刘洪臣², 姜华²()

^1.滨州医学院附属烟台口腔医院，烟台 264001
^2.中国人民解放军总医院第一医学中心口腔科，北京 100853
^3.首都医科大学附属北京口腔医院修复科，北京 100050
^4.北京市顺义区医院口腔科，北京 101300

收稿日期:2024-08-29 修回日期:2024-12-24 出版日期:2025-04-01 发布日期:2025-03-25
通讯作者: 姜华 E-mail:clairhu1@163.com;jh1225@163.com
作者简介:胡一帆，医师，硕士，E-mail：clairhu1@163.com
基金资助:
国家重点研发计划(2023YFC3605600);北京市科技新星交叉项目(202204-84208)

A preliminary analysis of the clinical characteristics of patients with temperature-sensitive temporomandibular joint disorder syndrome

Hu Yifan¹^,²(), Ma Bowen², Zhai Xiaoting³, Xu Xinyu², Wang Yihan⁴, Li Hongbo², Hu Min², Liu Hongchen², Jiang Hua²()

^1.The Affiliated Yantai Stomatological Hospital, Binzhou Medical University, Yantai 264001, China
^2.Dept. of Stomatology, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
^3.Dept. of Prosthodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
^4.Dept. of Stomatology, Beijing Shunyi Hospital, Beijing 101300, China

Received:2024-08-29 Revised:2024-12-24 Online:2025-04-01 Published:2025-03-25
Contact: Jiang Hua E-mail:clairhu1@163.com;jh1225@163.com
Supported by:
National Key Research and Development Plan(2023YFC3605600);Science and Technology Nova Cross Project of Beijing(20220484208)

摘要/Abstract

摘要：

目的分析对温度骤降敏感的颞下颌关节紊乱综合征（TMD）患者的临床症状及影像学表现。方法纳入2022年12月—2023年12月于解放军总医院第一医学中心口腔科就诊的TMD患者119例，其中男性44例，女性75例，平均年龄为32.4±13.7岁。通过调查问卷确定是否对温度骤降敏感，将TMD患者分为温度骤降敏感组和温度骤降不敏感组。观察2组患者的临床症状及影像学表现。采用SPSS 25.0软件进行统计学分析。结果温度骤降敏感组（50例）和温度骤降不敏感组（69例）患者的性别及年龄差异均无统计学意义（P>0.05）。温度骤降敏感组患者关节/咀嚼肌疼痛的比例［86.0%（43/50）］略高于温度骤降不敏感组［68.1%（47/69）］，差异有统计学意义（χ²=5.031，P=0.025），两组间关节杂音和下颌运动受限的差异均无统计学意义。检测两组患者共计238侧关节中，温度骤降敏感组出现骨关节病影像改变的比例［82.0%（82/100）］显著高于温度骤降不敏感组［53.6%（74/138）］（χ²=20.675，P<0.001）。核磁影像显示温度骤降敏感组患者关节积液的比例［66.0%（33/50）］高于温度骤降不敏感组［42.0%（29/69）］，差异有统计学意义（χ²=5.602，P=0.018）。结论伴有颌面部疼痛症状、关节积液和骨关节结构异常影像学表现的TMD患者更易对温度骤降敏感。

关键词: 颞下颌关节紊乱综合征, 温度骤降, 锥形线束计算机体层摄影术, 磁共振成像

Abstract:

Objective This study aims to analyze the clinical symptoms and imaging manifestations in patients with temporomandibular disorder syndrome (TMD), who are sensitive to sudden temperature drop. Methods One hundred and nineteen patients with TMD who attended the Department of Stomatology of the First Medical Center of Chinese People’s Liberation Army General Hospital from December 2022 to December 2023 were included, including 44 males and 75 females, with a mean age of 32.4±13.7 years.The questionnaire was used to determine whether they were sensitive to temperature drop, and the TMD patients were divided into a temperature plunge-sensitive group and a temperature drop insensitive group. The clinical symptoms and imaging manifestations of patients in the two groups were observed. SPSS 25.0 was used for statistical analysis. Results There was no statistically significant difference between the gender and age of patients in the temperature plunge-sensitive group (50 patients) and the insensitivity group (69 patients) (P>0.05). The percentage of patients with pain was slightly higher in the temperature plunge-sensitive group [86.0% (43/50)] than in the insensitive group [68.1% (47/69)], and the difference was statistically significant (χ²=5.031, P=0.025), while the differences in joint murmur and mouth opening limitation between the two groups were not statistically significant. A total of 238 lateral joints were detected in both groups, the percentage of osteoarthropathic imaging changes was significantly higher in the temperature plunge-sensitive group [82.0% (82/100)] than in the insensitive group [53.6% (74/138)] (χ²=20.675, P<0.001). Magnetic imaging showed that the percentage of joint effusion was higher in patients in the temperature plunge-sensitive group [66.0% (33/50)] than in the insensitive group [42.0% (29/69)], and the difference was statistically significant (χ²=5.602, P=0.018). Conclusion TMD patients with maxillofacial pain symptoms, joint effusions, and abnormal imaging of osteoarticular structures are more likely to be sensitive to sudden temperature drops.

Key words: temporomandibular joint disorder syndrome, plunge in temperature, cone-beam computed tomography, magnetic resonance imaging

中图分类号:

R782.6

胡一帆, 马博文, 翟孝庭, 徐鑫宇, 王一涵, 李鸿波, 胡敏, 刘洪臣, 姜华. 温度骤降敏感的颞下颌关节紊乱综合征患者的临床特点初步分析[J]. 华西口腔医学杂志, 2025, 43(2): 269-274.

Hu Yifan, Ma Bowen, Zhai Xiaoting, Xu Xinyu, Wang Yihan, Li Hongbo, Hu Min, Liu Hongchen, Jiang Hua. A preliminary analysis of the clinical characteristics of patients with temperature-sensitive temporomandibular joint disorder syndrome[J]. West China Journal of Stomatology, 2025, 43(2): 269-274.

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组别	例数/n	年龄/岁	性别/n（%）
组别	例数/n	年龄/岁	男性	女性
温度骤降敏感组	50	33.3±14.4	20（40.0）	30（60.0）
温度骤降不敏感组	69	31.4±13.5	24（34.8）	45（65.2）
t值或x²值		-1.196	0.339
P值		0.299	0.561

组别	例数	疼痛/n（%）	关节杂音/n（%）	张口受限/n（%）
温度骤降敏感组	50	43（86.0）	33（66.0）	29（58.0）
温度骤降不敏感组	69	47（68.1）	52（75.4）	33（47.8）
t值或x²值		5.031	1.245	1.202
P值		0.025*	0.264	0.273

组别	关节侧数	有骨关节病影像改变/n（%）	无骨关节病影像改变/n（%）
温度骤降敏感组	100	82（82.0）	18（18.0）
温度骤降不敏感组	138	74（53.6）	64（46.4）
x²值		20.675
P值		0.001**

组别	例数	关节积液/n（%）	移位侧别/n（%）		移位程度/n（%）
组别	例数	关节积液/n（%）	单侧	双侧	ADD-wR	ADD-woR
温度骤降敏感组	50	33（66.0）	15（30.0）	8（16.0）	24（48.0）	25（50.0）
温度骤降不敏感组	69	29（42.0）	28（40.6）	23（33.3）	30（43.5）	33（47.8）
x²值		5.602	0.693		0.020
P值		0.018*	0.405		0.886

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温度骤降敏感的颞下颌关节紊乱综合征患者的临床特点初步分析

A preliminary analysis of the clinical characteristics of patients with temperature-sensitive temporomandibular joint disorder syndrome

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