骨关节炎的药物治疗进展  

Advances of drug treatment in osteoarthritis

作　　者：董海涛[1] 杨占君[2] 董乐乐[1] 

机构地区：[1]内蒙古科技大学包头医学院一附院骨科,014010 [2]内蒙古科技大学包头医学院解剖教研室,014010

出　　处：《中国骨与关节杂志》2012年第3期284-288,共5页Chinese Journal of Bone and Joint

摘　　要：骨关节炎（osteoarthritis,OA）是最常见的关节疾病,主要表现为关节软骨退变、磨损、骨刺形成,导致关节肿胀、疼痛、畸形和功能障碍等.OA的发生与增龄、肥胖、损伤、免疫、生化和遗传等均有关.此外,细胞因子、生长因子、免疫因素等也与OA的发病有关.增龄是OA发展最主要的因素,机械和生物学因素相互影响是OA受累的原因.Osteoarthritis （OA） is the most common form of arthritis in human and the morbidity is about 2%-6%. OA always has different degraded parts of cartilage matrix. The inflammation of synovial membrane is the accompaniment of OA caused by degraded parts of cartilage matrix. The secretion of IL-1 increases and leads to the increase and activity of matrix metalloprotease causing the destruction of cartilage. Normal membrane cell only secretes a small amount of IL-1, but much more in OA. Type B cell becomes more active and secretes a large amount of IL- 1 after stimulated by sloughed cartilage matrix parts and worsens OA. We choose sodium hyaluronate （SH） and anti-metabolism cytotoxic drug, 5-Flurouracil （5-FU） for intra-articular injection. SH can increase the viscoelasticity and lubrication of joint synovial fluid. 5-FU acts on membrane cells to control its proliferation through inhibiting the synthesis of DNA to end the mitosis. That makes the amount of membrane not over increased and the amount of IL-I decreased. Decreased level of IL-1 depresses the secretton of MMP and improves the destruction of cartilage.

关 键 词：骨关节炎 药物治疗 关节软骨退变 免疫因素 生物学因素 关节疾病 主要表现 骨刺形成 

分 类 号：R684.3[医药卫生—骨科学]