骨关节炎发病机制的研究进展

The research progress of osteoarthritis pathogenesis

骨关节炎(osteoarthritis,OA)是一种以关节软骨变性和丢失及关节边缘和软骨下骨骨质再生为病理特征的慢性关节疾病。常见部位膝、髋、肘和收的小关节等。OA的病因尚不明确,但具有相似的生物学、形态学和临床特征。OA主要累及关节软骨、软骨下骨、关节囊及韧带、滑膜和周围肌肉。多见于中老年人,女性多于男性。随着老龄化社会的到来,OA患者数量将逐渐升高。到2020年老年人为发达国家人口总数的1/4,65岁以上的老年人所患慢性病一半为OA。我国大于60岁骨关节炎患者约1.3亿人,约占人口总数的30%。OA是影响人类健康最常见的关节疾患之一。骨关节炎严重威胁人类的健康和生活,一直是骨科科学研究的重要课题。虽然在OA的早期治疗和抑制其发展方向的投入较大,但在过去20年里,药物治疗方面也未取得长足的进步。尽管对关节软骨的生理、生化以及软骨细胞的代谢有了一定的了解,但OA的病因、发病机制至今尚不十分明确。因此对其早期诊断与治疗缺乏明确的针对性。骨关节炎的发病机制是由多种因素所致,包括基因遗传性;生物力学因素;软骨营养、代谢异常;软骨细胞凋亡等。现从关节软骨的结构、细胞因子学说、自由基学说、miRNA、STAT3等方面对骨关节炎的发病机制进行综述。

Osteoarthritis is a kind of chronic joint disease. The pathological features of osteoarthritis is articular cartilage degeneration and loss, bone regeneration of joint edge and the subchondral bone. The common parts of osteoarthritis are the knee, hip, elbow and small joints, etc. The cause of osteoarthritis is unclear, but with similar biology, morphology and clinical features. Osteoarthritis is mainly involving the articular cartilage, subchondral bone, joint capsule and ligaments, synovial membrane and the surrounding muscles. Osteoarthritis occurs in the elderly, more women than men.With the coming of aging society, osteoarthritis patients number will gradually rise. By 2020, the elderly population for a quarter of the total population in developed countries, half of all chronic diseases that suffered from by the elderly over the sixty-five age will be for“osteoarthritis”. There are about 130 million osteoarthritis patients older than sixty age in China, accounting for about 30% of the total population. Osteoarthritis is one of the most common joint disorders that affects human health. Osteoarthritis seriously threatens human health and life, it has been an important subject of orthopaedic science. Although the investment in the early treatment of osteoarthritis and inhibiting the developing direction is larger, but in the past 20 years, it has not obtained great progress in drug treatment. In spite of the articular cartilage of physiology, biochemistry and metabolism of chondrocyte have a certain understanding, but the etiology and pathogenesis of osteoarthritis is still not very clear. So for, its early diagnosis and treatment of the lack of a clear direction. The pathogenesis of osteoarthritis is caused by a variety of factors, including genetic heritage, biomechanical factors, cartilage nutritional and metabolic abnormalities, chondrocyte apoptosis, etc. Now, in this paper we reviewed the pathogenesis of osteoarthritis from the structure of the articular cartilage, cytokines theory, theory of free radicals, miRNA and STAT3.