骨质疏松症的发病机制及临床药物治疗研究进展

Research advances in the pathogenesis and clinical drug treatment of osteoporosis

骨质疏松症是一种全身性代谢性骨病,可以造成骨密度下降,骨微结构破坏,骨强度降低,进而增加患者骨折风险。随着我国人口老龄化形势的加剧,越来越多的患者正被骨质疏松症所困扰,并且,骨质疏松症及其相关并发症也不断影响患者日常生活活动能力并降低患者生活质量。近年来,国内外学者对本病的研究逐渐深入,其发病机制及临床诊治也取得了一定的进展。文献检索发现,慢性肝肾脏功能障碍、酗酒、内分泌功能紊乱等疾病可以通过影响骨代谢而影响骨质疏松症的发病,Wnt信号通路、骨生长因子相关信号通路、RANKL/RANK/OPG信号通路是影响骨质疏松症发病的较为关键信号通路;而双膦酸盐类药物、地舒单抗等是目前临床抗骨质疏松治疗的常用药物,对于骨质疏松性骨折高风险人群可尝试使用特立帕肽、罗莫单抗等骨形成药物,合理的药物序贯治疗有助于增强抗骨质疏松治疗效果。本文将对上述进展展开综述,以期提高临床医师及社会对本病的认识,并促进临床医师做出更好的治疗决策。

Osteoporosis is a systemic metabolic bone disease,which can cause decreased bone density,bone microstructure destruc-tion,and decreased bone strength,thus increasing the risk of fracture.With the aging of China’s population,an increasing number of patients are suffering from osteoporosis.This condition and its related complications continue to affect patients’daily activities and re-duce their quality of life.In recent years,global researchers have conducted increasingly in-depth research on this disease,leading to progress in its pathogenesis and clinical diagnosis and treatment.Literature search revealed that chronic liver and kidney dysfunction,alcohol consumption,and endocrine dysfunction can affect the development of osteoporosis by influencing bone metabolism.The Wnt signaling pathway,bone growth factor related signaling pathway,and RANKL/RANK/OPG signaling pathway are the key signaling path-ways affecting the development of osteoporosis.Moreover,bisphosphonates and denosumab are commonly used drugs in the clinical treatment of osteoporosis.For individuals at high risk of osteoporotic fractures,bone-forming agents such as teriparatide and romoso-zumab can be considered.A rational sequence of drug therapy can help enhance the effectiveness of osteoporosis treatment.In this ar-ticle,we will review the above advances to raise the awareness of cli-nicians and society about this disease,and help clinicians make bet-ter treatment decisions.