激素性股骨头缺血性坏死的发病机制

Pathogenesis of steroid-induced avascular necrosis of femoral head

糖皮质激素诱导的股骨头缺血性坏死(steroid-induced avascular necrosis of femoral head, SANFH)是一种代谢性疾病,由于临床上使用糖皮质激素药物不当,导致股骨头内部血液供给系统受损以及骨细胞和骨髓各组织成分的死亡,进而可能导致股骨头结构的改变、股骨头塌陷和关节功能的障碍。由于股骨头经常塌陷和髋关节功能障碍,成人SANFH是一种具有挑战性的骨科疾病。最终,患者需要全髋关节置换术,这将会严重降低患者日常生活的质量。然而,该病的发病机制仍然不明确。近年来,随着精准医学的进一步发展以及对干细胞和分子生物学的广泛深入研究,人们正在研究SANFH的确切发病机制,并探索更多新的治疗方法。这篇综述讨论了关于SANFH发病机制的几种主要理论学说。

Steroid-induced avascular necrosis of the femoral head(SANFH) is a metabolic disease that occurs due to improper clinical use of glucocorticoid. The blood supply system inside the femoral head is impaired and the tissue components of bone cells and bone marrow die, which may lead to structural changes of the femoral head, collapse of the femoral head and joint dysfunction. SANFH in adults is a challenging orthopedic disorder due to collapse of the femoral head in the end-stage with hip dysfunction eventually, which seriously compromises the patient’s quality of daily life, and will need total hip replacement, however, the pathogenesis of the disease remains unclear. In recent years, exact pathogenesis of SANFH and more new treatments for it are conducting with the further development of precision medicine and extensive and in-depth research on stem cells and molecular biology. This review discusses several leading theories about the pathogenesis of SANFH.