重视骨塑建在骨质疏松症防治中的作用

Attach importance to the role of bone modeling in the prevention and treatment of osteoporosis

骨塑建(bone modeling)与骨重建(bone remodeling)是人体骨骼生理代谢过程中的两种不同方式;两者都涉及骨形成与骨吸收,但两者具有很大差异。骨塑建包括成骨细胞形成的"成骨漂移"及破骨细胞形成的"破骨漂移",成骨细胞与破骨细胞互相独立而又内在协调,最终促使骨骼形态、结构发生改变;骨重建是成骨细胞与破骨细胞紧密偶联,最终完成"骨形成-骨吸收"动态平衡或失衡,多表现为骨矿物质量的正常维持或逐渐减少。既往文献认为引起骨塑建的成骨和破骨活动通常在骨发育成熟后即停止(或结束),而近些年有研究证实骨塑建可以贯穿人的一生,并非只活跃在婴幼儿时期;尤其在骨质疏松症范畴,部分抗骨质疏松症药物可对骨塑建过程产生显著影响,这也提示促进骨塑建方法可能是提高骨量的另外一个有益途径。因此,在骨质疏松症防治领域,重视骨塑建的作用,将对骨质疏松症患者预防、治疗产生重要意义。

Bone modeling and bone remodeling are two different approaches to the physiological metabolism of the human skeleton;both involve bone formation and bone resorption,but they are very different.Bone modeling includes osteoblasts in formation drifts and osteoclasts in resorption drifts,where osteoblasts and osteoclasts are independent of each other but intrinsically coordinated,contributing to changes in bone morphology and structure ultimately.Bone remodeling is a process in which osteoblasts and osteoclasts are closely coupled,resulting in a dynamic balance or imbalance between bone formation and bone resorption,mostly in the form of normal maintenance or gradual reduction of bone mineral mass.Previous literature has suggested that the osteogenic and osteoclastic activities that cause bone modeling usually cease(or end)when the bone matures,but recent studies have shown that bone modeling can occur throughout life and is not only active during infancy and early childhood.Particularly in the context of osteoporosis,some bone-sparing medication can have a significant effect on the process of bone modeling,suggesting that promoting bone modeling may be another useful way to increase bone mass.Therefore,in the field of osteoporosis prevention and treatment,focuse on the role of bone modeling will be significant for patients with osteoporosis.