腱病相关基础研究：微观生物力学与应力屏蔽

Basic science related to tendinopathy: microbiomechanics and stress shielding

背景:肌腱是一种特殊的结缔组织,可以将肌肉产生的力通过腱止点传递到骨骼上,腱病的发生与肌腱和腱止点的力学特性与其微细结构关系密切,但其中的具体机制仍有许多疑问。目的:综述肌腱和腱止点的微细结构、肌腱的生物力学特点、肌腱损伤的愈合与修复及慢性腱病相关的生物力学因素。方法:检索中国期刊网全文数据库(中国知网CNKI)、维普数据库、中国生物医学文献数据库(CBM)、中国医药学位论文全文数据库(万方)及PubMed数据库和Embase医药数据库,选择与腱病或腱止点相关微细结构、腱病或腱止点与应力之间关系及腱病或腱止点相关生物力学机制相关的文献。结果与结论:肌腱和腱止点的生物力学特性与其微细结构密切相关,肌腱在损伤修复过程中由于微细结构受到了影响,因此其生物力学特性也相应的降低。慢性腱病的发生发展与腱止点微细结构与生物力学特性有关,这其中压缩负荷与发生在腱止点上的应力屏蔽可能起着关键作用,但在具体的作用机制方面仍需要更多的高质量文献支持。

BACKGROUND:Tendon is a special connective tissue that can transmit the force generated by the muscle to the bone through the enthesis.The occurrence of tendinopathy is closely related to the mechanical characteristics of tendon and enthesis and its micro-structure,but the specific mechanism still remains controversial.OBJECTIVE:To summarize the micro-structure of tendon and enthesis,the biomechanical characteristics of tendon,the healing and repair of tendon injuries,and the biomechanical factors related to chronic tendinopathy.METHODS:CNKI,VIP,CBM,WanFang,PubMed and Embase databases were searched.The articles concerning micro-structure of tendon and enthesis,relationship between tendinopathy/enthesis and stress,and biomechanical mechanisms of tendinopathy/enthesis were selected.RESULTS AND CONCLUSION:The biomechanical properties of tendon and enthesis are closely related to their microstructures.The biomechanical properties of tendon are reduced due to the damage of their microstructures in the process of repair.The occurrence and development of chronic tendinopathy are related to the microstructures and biomechanical characteristics of enthesis.Compression load and stress shielding of enthesis may play a key role,but further high-quality studies on the specific mechanism are still required.