|
| 类风湿关节炎相关骨质疏松研究评析 |
| A review on rheumatoid arthritis associated osteoporosis |
| |
| DOI：10.3969/j.issn.1006.7108.2016.12.022 |
| 中文关键词: 类风湿关节炎；骨质疏松 糖皮质激素；骨代谢 |
| 英文关键词:Rheumatoid arthritis Osteoporosis Glucocorticoid Bone metabolism |
| 基金项目:国家临床重点专科中医风湿病学建设项目（财社 [2013]239号）；国家自然科学基金（81473672) |
|
| 摘要点击次数: 680 |
| 全文下载次数: 468 |
| 中文摘要: |
| 类风湿关节炎（rheumatoid arthritis，RA)与骨质疏松（osteoporosis, OP)在临床上都属于常见疾病，RA在引起继发性骨质疏松中占有重要地位，RA所导致的骨质疏松伴有骨脆性增加，导致骨折的发生率增加，降低了治愈率,增加了患者家庭及社会的负担。RA引起骨质疏松的发病机制并不十分清楚，但RANK/RANKL/OPG信号转导通路系统及炎症因子与其发生有一定关联。RA骨质疏松的发生与下列因素相关：RA病程的长短、疾病的活动程度、糖皮质激素的使用。对于大剂量使用糖皮质激素会导致骨质疏松这一危险因素巳达成共识,然而，对于小剂量使用糖皮质激素是否会造成骨质疏松仍然存在一些分歧； 慢作用抗风湿药物及生物制剂的使用与骨质疏松的发生无明显相关。及时控制关节炎症可以减少关节结构损伤、减少骨量流失。对于早期没有特异性症状的骨质疏松可采用传统的检查工具检测，也可用最新软件骨折危险性评估工具来筛查；随着对骨细胞分子生物学研究的深人，一些靶点治疗的新药也陆续发现，为抗骨质疏松的药物治疗提供了新选择。本文从RA相关骨质疏松的流行病学、发病机制以及骨质疏松的预防与治疗3方面来进行论述，以期加深临床工作者对RA并发骨质疏松的认识和重视。 |
| 英文摘要: |
| Rheumatoid arthritis (RA) and osteoporosis (OP) are common clinical diseases. RA is one of the major causes of secondary osteoporosis. RA induced osteoporosis is associated with increased bone fragility, increased fractures incidence, reduced healing rate and increased burden to families and the society. The pathogenesis of osteoporosis induced by RA is not very clear, but the RANKL/OPG/RANK signal transduction pathway system and inflammatory factors are correlated with the occurrence of osteoporosis. The occurrence of osteoporosis with RA was related to the following factors：the length of the course of RA, the degree of disease activity, and the use of glucocorticoids. There is a consensus on the use of glucocorticoids as a risk factor for osteoporosis, however, there are still some different views on whether the use of low dose glucocorticoids could cause osteoporosis. There were no significant correlations between the use of slow acting anti-rheumatic drugs and biological agents and the occurrence of osteoporosis. Controlling joint inflammation in time can reduce the damage to joint structure and reduce the loss of bone mass. Early non-specific symptoms osteoporosis can be detected using traditional assessment tools, and the latest software also can be used to assess the risk of fracture. With further research on the molecular biology of bone cells, some new drugs have been discovered, which provide a new choice for the treatment of osteoporosis. This paper reviewed from three aspects of RA related osteoporosis, including current progress in epidemiological studies，pathophysiological mechanism，and prevention and treatment of osteoporosis, in order to improve the knowledge and understanding of clinic workers in RA associated osteoporosis. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |