激素性股骨头坏死发生机制的研究进展△

Research progress on the mechanism of glucocorticoid-induced osteonecrosis of the femoral head

摘要:

糖皮质激素是引发股骨头坏死的非创伤因素的主要病因之一，目前仍是一种复杂的难治性疾病，其相应的机制目前仍不够明确。以往认为血供受损、内皮损伤、凝血障碍、血栓形成、脂质代谢异常及细胞凋亡等机制扮演着重要角色。近年来，发现非编码 RNA 及遗传易感性在股骨头坏死机制中的重要性，并随着更多的信号通路和细胞因子被揭示，有望通过对疾病中某个或多个相互作用的过程进行干预，逆转激素对股骨头所造成的不利影响。本文主要总结了因糖皮质激素造成股骨头坏死的病理生理机制，为未来激素性股骨头坏死的研究及治疗提供理论依据。

Abstract:

Glucocorticoid is one of the main causes leading to non-traumatic femoral head necrosis, a refractory disease in clinical prac- tice, which remains not clear completely in pathogenesis mechanism. Previous several hypotheses for explaining the mechanisms, such as im- paired blood supply, endothelial injury, coagulation disorders, thrombosis, abnormal lipid metabolism and cell apoptosis, were thought to play important roles. In recent years, small non-coding RNAs and genetic susceptibility have been found to be related to the mechanism of femoral head necrosis, with increasing numbers of signaling pathways and cytokines revealed in the disease. It is hoped that we can reverse the pathogenesis of the femoral head by intervening in one or more of the interacting processes in the disease. This paper mainly summarized the pathophysiological mechanism of ONFH caused by corticosteroid to provide a theoretical reference for future research and clinical treat- ment of steroid-induced femoral head necrosis.