摘要
强直性脊柱炎(ankylosing spondylitis,AS)是一种主要侵犯脊柱、骶髂关节、髋关节的慢性进展性风湿性疾病。AS患者常继发骨质疏松(osteoporosis,OP),常见检测方法是平片X线摄影、双能X线吸收法、定量计算机断层扫描。AS患者继发OP的发生机制尚不明确。细胞核因子κB受体活化因子(receptor activator of nuclear factor kappa B,RANK)、细胞核因子κB受体活化因子配体(receptor activator of nuclear factor kappa B ligand,RANKL)、骨保护素(osteoprotegerin,OPG)构成的通路功能紊乱导致破骨细胞活化可能是重要机制之一;Wnt通路的两类调控蛋白的表达异常也可能参与了OP的发生;各种炎症因子,如肿瘤坏死因子(tumor necrosis factor,TNF)、白细胞介素(interleukin,IL)等也可能与AS患者OP的形成有关。国际AS指南对OP治疗没有统一的标准。TNF-α抑制剂、双磷酸盐类、中西医结合疗法都有一定的治疗效果,但仍需要进一步研究证明。
Ankylosing spondylitis（ AS） is a chronic progressive rheumatic disease which mainly invades the spine,sacroiliac joint,and hip joint. Osteoporosis（ OP） secondary to AS is common and can be detected by X-ray photograph,dual energy X-ray absorptiometry,and quantitative computed tomography. The mechanism of OP secondary to AS still remains obscure. Activation of osteoclast induced by dysfunction of receptor activator of nuclear factor kappa B（ RANK）,receptor activator of nuclear factor kappa B ligand（ RANKL）,or osteoprotegerin（ OPG） pathway is a possible mechanism. Abnormal expression of two regulatory proteins of Wnt pathway may also contribute to the onset of OP. Inflammatory factors such as tumor necrosis factor（ TNF） and interleukin（ IL） may be involved in the development of OP. International guideline on AS has no unified standard for the treatment of OP.TNF-α inhibitor,bisphosphonates,and combined traditional Chinese and western medicine have certain effect on the treatment of OP,but the efficacy needs further study.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2016年第5期628-631,共4页
Chinese Journal of Osteoporosis
关键词
强直性脊柱炎
骨质疏松
检测
治疗
Ankylosing spondylitis
Osteoporosis
Detection
Therapy
