[關(guān)鍵詞]
[摘要]
類風(fēng)濕性關(guān)節(jié)炎(RA)骨代謝紊亂可導(dǎo)致骨密度降低及骨脆性增加,一方面可能是由于疾病本身的炎癥環(huán)境及免疫異常引起,另一方面糖皮質(zhì)激素等藥物的干預(yù)也可能加重骨質(zhì)疏松的發(fā)生。RA骨代謝紊亂隨著病程進(jìn)展及炎癥反應(yīng)呈進(jìn)行性加重,早期可表現(xiàn)有關(guān)節(jié)軟骨破壞及骨端骨質(zhì)疏松,晚期可累及四肢、腰椎的骨密度降低脆性增加,甚至全身性骨質(zhì)疏松的發(fā)生。明確RA骨破壞特點(diǎn)對(duì)RA骨代謝紊亂的診斷及針對(duì)性防治具有重要作用,對(duì)改善風(fēng)濕病患者的生活質(zhì)量及疾病控制具有重要意義。綜述了近年RA骨代謝異常及藥物干預(yù)相關(guān)研究進(jìn)展,首先從骨代謝紊亂的發(fā)病率、累及的不同骨組織以及可能發(fā)病機(jī)制對(duì)RA骨代謝紊亂的表現(xiàn)進(jìn)行了總結(jié),在此基礎(chǔ)上從緩解RA病情藥物、生物制劑以及中醫(yī)藥防治RA骨代謝紊亂作用進(jìn)行了藥物干預(yù)現(xiàn)狀的總結(jié),以期為RA骨破壞的治療提供一定參考。
[Key word]
[Abstract]
Rheumatoid Arthritis (RA) related bone metabolism disorders could lead to decreased bone density and increased bone fragility. It may be caused by the of the RA disease related inflammatory environment and immune abnormalities, on the other hand, the intervention of drugs, such as glucocorticoids, may also increase the occurrence of osteoporosis. RA related bone metabolism disorders is progressively aggravated with the progression of the disease and the inflammatory response. In the early stage, it can show the destruction of articular cartilage and osteoporosis. In the late stage, the bone density of the limbs and lumbar spine can be reduced, even the occurrence of systemic osteoporosis. To clarify the characteristics of RA bone destruction would play an important role in the diagnosis and treatment of RA bone metabolism disorders, and it would be of great significance in improving the quality of life and disease control of RA patients. Therefore, this review summarized the recent research progress of RA bone abnormalities and drug intervention. The incidence of bone metabolic disorders, the different bone tissues involved, the possible pathogenesis of bone metabolic disorders and the intervention effect of drugs are summarized in order to provide some clues for the treatment of RA related bone metabolism disorders.
[中圖分類號(hào)]
R969
[基金項(xiàng)目]