他汀类药物用于人工关节无菌性松动的防治

Usage of statins for the prevention and treatment of aseptic loosening of artificial joint

背景:人工关节无菌性松动是影响关节假体寿命最主要的因素。他汀类药物被发现具有稳定人工关节无菌性松动的新作用。目的:从药理机制、临床实验、不良反应的最新研究进展3方面进行综述,为药物预防人工关节无菌性松动提供参考。方法:由第一作者应用计算机检索PubMed和中国期刊全文数据库(CNKI)2007至2011年相关文献。在标题摘要关键词中以"statins,artificialjoint,asepticloosening,prosthesis,osteolysis"或"他汀类药物;人工关节;无菌性松动;假体;骨溶解"为检索词进行检索。选择文章内容与他汀类药物预防人工关节无菌性松动有关者,同一领域文献则选择近期发表在权威杂志文章。初检得到167篇文献,根据纳入标准选择筛选出33篇文献进行综述。结果与结论:他汀类具有促进假体周围新骨形成、增强的三点弯曲力量进而稳定人工关节周围骨结构的新作用,同时也有实验表明高剂量的辛伐他汀可能对多发性骨髓瘤患者有害、在一定浓度可能引起炎症反应等。作为预防人工关节无菌性松动的新药物,还需要进行进一步的研究以确定最佳的治疗阈值、给药方式和对人类骨再生的有效性。

BACKGROUND：The most significant factor that affects the life span of joint prosthesis is the artificial joint aseptic loosening.Statins were found that it can stable artificial jointaseptic loosening.OBJECTIVE：To review from three areas,including pharmacological mechanism,clinical trials and adverse reactions,in order to provide reference for clinical practice of statins on the prevention of artificial joint aseptic loosening.METHODS：A computer-based online search of PubMed database and CNKI database between 2007 and 2011 was performed to search related articles with the key words of ＂statins,artificial joint,aseptic loosening,prosthesis,osteolysis＂ in English or Chinese.Literatures related to statins for the prevention of artificial joint aseptic loosening were selected,and for the articles in the same field,we preferred the ones published recently or in authorize journals.A total of 167 literatures were primarily selected,and 33 documents were involved for summary according to inclusion criteria.RESULTS AND CONCLUSION：Statins can promote the formation of new bone around prosthesis,enhance the three-point bending strengths and stabilize the structure of bone around the prosthesis.However,some experiments show that high doses of simvastatin might be harmful in multiple myeloma patients,as it can results a inflammation in certain concentration.As a new drug for preventing artificial jointaseptic loosening,further studies to determine the best drug threshold,administration methods and value of human bone regeneration are very important.