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| 强直性脊柱炎骨化临床研究进展 |
| The progress of clinical research in bone formation in ankylosing spondylitis |
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| DOI：10.3969/j.issn.1006.7108.2015.12.020 |
| 中文关键词: 强直性脊柱炎；骨化；临床研究 研究进展 |
| 英文关键词:Ankylosing spondylitis Bone formation Clinical research Research progress |
| 基金项目:国家自然科学基金面上项目（81373562);国家自然科学基金青年项目（81403378);北京市自然科学基金青年基金 (7144241）；中日友好医院青年科技英才培养计划（2014-QNYC-B- 02) |
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| 中文摘要: |
| 强直性脊柱炎（ankylosing spondylitis, AS)是脊柱关节病中最常见的疾病，早期以炎症为主，晚期可出现骨质疏松和骨化两种看似矛盾的表现,骨化的研究有助于AS的治疗。骨化是导致患者出现相关症状、功能障碍、甚至残疾的主要原因。骨化主要发生于脊柱，因为病变组织不易获取，且病程漫长，个体间差异大，目前研究进展缓慢。AS患者骨化平均每年改良的 Stoke强直性脊柱炎脊柱评分（modified Stoke’s AS spine score，mSASSS)进展1分，仅不到30%的患者出现较快进展。基线时炎症与骨化进展有关，主要是红细胞沉降率（erythrocyte sedimentation rate,ESR)、C-反应蛋白（C-reactive protein,CRP)、强直性脊柱炎疾病活动指数（ankylosing spondylitis disease activity score, ASDAS)等客观炎症指标，而与基于患者自我报告结果 (patient-reported outcome，PRO)的 Bath 强直性脊柱炎疾病活动指数（bath ankylosing spondylitis disease activity index, BASDAI) 关系不明确。此外，基线时已存在的骨化程度、磁共振成像（magnetic resonance imaging,MRI)骨髓脂肪沉积、吸烟等也是骨化预测因素。非甾体抗炎药和肿瘤坏死因子拮抗剂对延缓AS病理性成骨的作用尚不明确。 |
| 英文摘要: |
| Ankylosing spondylitis (AS) is the most common form of spondyloarthritis. It is characterized by inflammation in the early stage, but by paradoxical symptoms of both osteoporosis and bone formation in the later period. The research in bone formation may contribute to the treatment of AS. The bone formation is the dominant reason contributing to AS-associated symptoms, loss of function, and disability. Bone formation occurs mainly in the spine. Because of the difficulty of collecting diseased bone tissue, long-term disease course, and individual variation, the progress in research is slow. The mean rate of progression of spinal bone formation is around 1 modified Stoke’s AS spine score (mSASSS) unit per year, while only less than 30% of AS patients may have significant progression. At baseline, inflammation has been linked to bone formation, and it is associated with erythrocyte sedimentation rate (ESR)，C-reactive protein (CRP), or the AS disease activity score (ASDAS). It is not associated with Bath AS disease activity index (BASDAI), which is mainly based on the patient-reported outcome (PRO). Meanwhile, existing bone formation at baseline, bone marrow lipid deposition shown in MRI, and smoking are predicting factors of bone formation. The effect of non-steroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor inhibitor (TNFi) in delaying the progress of ankylosis is still unclear. |
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