慢性鼻窦炎骨质重塑的临床研究进展  

Clinical research progress on bone remodeling in chronic rhinosinusitis

作　　者：方甜甜 陈曙光 张旭 钟业鸣 车子刚[2] Fang Tiantian;Chen Shuguang;Zhang Xu;Zhong Yeming;Che Zigang(Department of Ultrasound,Nanjing Tongren Hospital/Southeast University School of Medicine,Nanjing 211100,China;Department of Medical Imaging,Nanjing Tongren Hospital/Southeast University School of Medicine,Nanjing 211100,China)

机构地区：[1]东南大学医学院附属南京同仁医院超声科,南京211100 [2]东南大学医学院附属南京同仁医院医学影像科,南京211100

出　　处：《中华解剖与临床杂志》2025年第2期139-144,共6页Chinese Journal of Anatomy and Clinics

基　　金：南京市卫生科技发展专项资金(YKK23263)。

摘　　要：目的总结慢性鼻窦炎(CRS)骨质重塑的临床研究进展。方法以“慢性鼻窦炎”“骨质重塑”“骨炎”“骨髓炎”“骨质增生”“新成骨”“骨形成”或“chronic rhinosinusitis”“bone remodeling”“osteitis”“osteomyelitis”“bone hyperplasia”“new bone formation”“ossification”为关键词,在中国知网、万方数据库、中华医学期刊全文数据库、PubMed及Web of Science数据库检索1992年1月—2024年6月发表的有关CRS骨质重塑的文献258篇,排除内容不符、证据等级较低及重复的文献,最终纳入45篇文献。从CRS骨质重塑的发生机制、组织病理学、影像学诊断、治疗,以及骨质重塑对CRS的影响等方面进行分析、汇总。结果CRS骨质重塑的发生机制包括破骨细胞介导对骨质的清除和成骨细胞介导对骨质的取代过程,在细胞及分子水平上受多种因素影响。组织病理学证实了CRS骨质重塑的存在,但确切的病理过程有待进一步研究。CT能够显示骨质结构细节及密度差别,在诊断CRS骨质重塑中具有一定的优势,同时影像分级评价系统已逐渐完善,但仍缺乏标准化和统一性。对于CRS骨质重塑的治疗目前应用最广泛的仍是手术切除。骨质重塑对CRS的转归及预后有显著的影响。结论CRS骨质重塑的概念还较新,尽管研究已经取得了良好的进展,但目前对其确切的发病机制和病理生理发展规律仍不清楚,影像学评估方法和标准也尚未统一。随着近年来CT影像评估系统的提出,CRS骨质重塑的人工智能辅助诊断检测模型也将不断发展。Objective This study aimed to explore the clinical research progress on bone remodeling in chronic rhinosinusitis(CRS).Methods With keywords such as"慢性鼻窦炎""骨质重塑""骨炎""骨髓炎""骨质增生""新成骨""骨形成""chronic rhinosinusitis""bone remodeling""osteitis""osteomyelitis""bone hyperplasia""new bone formation"and"ossification"258 articles on CRS bone remodeling published from January 1992 to June 2024 were retrieved from databases,including CNKI,Wanfang Database,Full-text Database of Chinese Medical Journals,PubMed,and Web of Science.After articles with inconsistent content,low evidence level,and duplication were excluded,45 articles were ultimately included.Analysis and summary were conducted in terms of occurrence mechanism,histopathology,imaging diagnosis,treatment of CRS bone remodeling,and its influence on CRS.Results The mechanism of bone remodeling in CRS includes osteoclasto-mediated clearance of bone and osteoblasto-mediated replacement of bone,which are affected by many factors at the cellular and molecular levels.Histopathology confirmed the existence of bone remodeling in CRS,but the exact pathogenesis needs further study.CT has certain advantages in the diagnosis of bone remodeling in CRS because it shows bone structure details and density differences.The image grading evaluation system is gradually improved,but it still lacks standardization and uniformity.Surgical resection remains the most widely used treatment for CRS bone remodeling,and bone remodeling has a significant impact on the outcome and prognosis of CRS.Conclusion The concept of bone remodeling in CRS is still relatively new,and although good progress has been achieved in research,the exact pathogenesis and pathophysiological development remain unclear,and imaging evaluation has not been unified.With the proposed systematic evaluation of CT in recent years,artificial intelligence assisted diagnostic detection models for CRS bone remodeling are expected to continuously develop.

关 键 词：鼻窦炎 慢性鼻窦炎 骨质重塑 骨炎 研究进展 

分 类 号：R76[医药卫生—耳鼻咽喉科]