类风湿关节炎患者骨代谢标志物研究进展

Research progress on bone metabolism in rheumatoid arthritis patients

类风湿关书炎是以慢性进行性软骨和骨破坏及滑膜改变为特征的自身免疫性疾病，骨降解、修复失衡是导致关节破坏的主要原因。传统的实验室诊断项目及放射性方法检测出病情较晚，且对监测病情进展缺乏敏感性。现发现体内骨代谢标志物水平的改变可以反映成骨细胞和破骨细胞的活性，为疾病的早期诊断、治疗、监测预后提供了新的方法。此文就滑膜、软骨、骨标志物三大方面来阐述骨代谢标志物在临床类风湿性关节炎诊断和治疗方面的应用。

Rheumatoid arthritis （RA） is a chronic inflammatory autoimmune disease characterized by chronic progressive destruction of cartilage and bone and by synovial changes. Joint damage is likely to result pri- marily from an imbalance between cartilage degradation and repair. Traditional biological markers and imaging techniques help diagnosis RA lately and have poor sensitivity. A few bone remodeling markers have been studied in RA reflect osteoblast and osteoelast activation, providing a new way to diagnose, treatment and monitoring prog- nosis. In this review, the clinical applications of synovial markers, cartilage markers and bone markers in patients with RA are discussed.