骨关节炎的发病机制及其诊治的研究进展_West China Medical Journal

Authors：

谭静雅 ,  杨南萍

Corresponding author：

杨南萍, Email: tynnej@vip.qq.com

Keywords：

骨关节炎; 发病机制; 诊断标准; 临床治疗

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面对人口的老龄化趋势及人类寿命的延长，骨关节炎（OA）越来越多见。随着对OA发病机制认识的不断深化，研究工作者们从OA危险因素到病理学改变，从分子生物学改变到免疫学改变，多方面、多角度地研究OA的发病机制。而其临床诊断主要依靠症状体征、影像学和实验室检查相结合，治疗方面在早中晚期可以分别通过保守药物治疗和手术治疗缓解疼痛并改善功能。因此，阐明OA的发病机制，将有利于提高对OA的认识及早期诊断，也是指导OA实验研究及临床治疗的理论依据。

Citation： 谭静雅,杨南萍. 骨关节炎的发病机制及其诊治的研究进展. West China Medical Journal, 2012, 27(12): 1828-1832. doi: Copy

1.	Felson DT. Epidemiology of knee and hip osteoarthritis[J]．Epidemiol Rev, 1988, 10(8): 1-28.
2.	Martin JA, Buckwalter JA. Aging, articular cartilage chondrocyte senescence and osteoarthritis[J]. Biogerontology, 2002, 3(5): 257-264．.
3.	D’Ambrosia RD. Epidemiology of osteoarthritis[J]. Orthopedics, 2005, 28(Suppl 2): 201-205．.
4.	Peixoto JG, Dias JM, Dias RC, et al. Relationships between measures of muscular performance, proprioceptive acuity, and aging in elderly women with knee osteoarthritis[J]. Arch Gerontol Geriatr, 2011, 53(2): 253-257.
5.	Tanamas SK, Wijethilake P, WIuka AE, et al. Sex hormones and structural changes in osteoarthritis: a systematic review[J]. Maturitas, 2011, 69(2): 141-146.
6.	薛延, 李东, 姚力, 等．雌激素受体等位基因多态性与骨关节炎的关系[J]．中华风湿病学杂志, 2004, 8(10): 583-586．.
7.	庞璨, 贾伟平．脂肪组织缺氧与肥胖相关性炎症的研究现状[J]．中华医学杂志, 2008, 88(36): 2588-2591.
8.	Jacobsen S, Sonne-Holm S, S balle K, et al. Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the osteoarthrosis sub-study of the copenhagen city heart study[J]. Acta Orthop, 2005, 76(2): 149-158．.
9.	季锦飞, 戴进, 史冬泉, 等．遗传因素和机械因素与膝骨性关节炎发病年龄的关系[J]．中华医学遗传学杂志, 2010, 27(6)：672-674．.
10.	Weiss E, Jurmain R. Osteoarthritis revisited: a contemporary review of aetiology [J]. Int J Osteoarchaeol, 2007, 17(5): 4372-4450.
11.	Nakajima M, Miyamoto Y, Ikegawa S. Cloning and characterization of the osteoarthritis-associated gene DVWA[J]. J Bone Miner Metab, 2011, 29(3): 300-308．.
12.	Li X, Gibson G, Kim JS, et al. MicroRNA-146a is linked to pain-related pathophysiology of osteoarthritis [J]. Gene, 2011, 3(21): 250-265.
13.	Amiable N, Martel-Pelletier J. Lussier B, et al. Proteinase-activated receptor-2 gene disruption limits the effect of osteoarthritis on cartilage in mice：a novel target in joint degradation [J]. J Rheumatol, 2011, 38(5): 911-920.
14.	Wang YH, Ni XH, Xu DW, et al. Expression of β-1, 4-galactosyl-transferase I in a surgically-induced rat model of knee osteoarthritic synovitis [J]. Chin Med J (Engl), 2010, 123(21): 3067-3073.
15.	Santangelo KS, Pieczarka EM, Nuovo GJ, et al. Temporal expression and tissue distribution of interleukin-lt3 in two strains of guinea pigs with varying propensity for spontaneous knee osteoarthritis [J]. Osteoarthritis Cartilage, 2011, 19(4): 439-448.
16.	Legendre F, Bogdanowicz P, Boumediene K, et al. Role of interleukin 6(IL-6)/IL-6R-induced signal tranducers and activators of transcription and mitogen-activated protein kinase [J]. J Rheumatol, 2005, 32(7): 1307-1316.
17.	Kubo S, Cooper GM, Matsumoto T, et al. Blocking vascular endothelial growth factor with soluble Flt-1 improves the chondrogenic potential of mouse skeletal muscle-derived stem cells [J]. Arthritis Rheum, 2009, 60(1): 155-165.
18.	Ekenstedt KJ, Sonntag WE, Loeser RF, et al. Effects of chronic growth hormone and insulin-like growth factor ideficiency on osteoarthritis severity in rat knee joints[J]. Arthriths Rheun, 2006, 54(12): 3850-3858.
19.	周建林,刘世清,邱波.兔骨关节炎滑膜组织血管内皮生长因子mRNA表达及透明质酸钠的影响[J]. 中国组织工程研究与临床康复, 2010, 14(11): 1983-1986.
20.	Yuan GH, Masuko-Hongo K, Kato T, et al. Immunologic intervention in the pathogenesis of osteoarthritis[J]．Arthritis Rheum, 2003, 48(3): 602-611.
21.	Ley C, Ekman S, Ron6us B, et a1. Interleukin-6 and high mobility group box protein-1 in synovial membranes and osteochondral fragments in equine osteoarthritis[J]. Res Vet Sci, 2009, 86(3): 490-497.
22.	Shen PC, Wu CL, Jou IM, et al. T helper cells promote disease progression of osteoarthritis by inducing macrophage inflammatory protein-1γ[J]. Osteoarthritis Cartilage, 2011, 19(6): 728-736.
23.	Thomas CM, Fuller CJ, Whittles CE, et al. Chondrocyte death by apoptosis is associated with cartilage matrix degradation[J]. Osteoarthritis Caritlage, 2007, 15(1): 27-34.
24.	Summers GC, Merrill A, Sharif M, et al. Swelling of articular cartilage depends on the integrity of adjacent cartilage and bone[J]. Biorheology, 2008, 45(3-4): 365-374.
25.	Wei L, Sun X, Wang Z, et al. CD95-induced osteoarthritic chondrocyte apoptosis and necrosis：dependency on p38 mitogen-activated protein kinase[J]. Arthritis Res Ther, 2006, 8(2): 37.
26.	Thomas CM, Whittles CE, Fuller CJ, et al. Variations in chondrocyte apoptosis may explain the increased prevalence of osteoarthritis in some joints[J]. Rheumatol Int (forthcoming), 2011(10): 1341-1348.
27.	Almonte-Becerril M, Navarro-Garcia F, Gonzalez-Robles A, et al. Cell death of chondrocytes is a combination between apoptosis and autophagy during the pathogenesis of osteoarthritis within an experimental model[J]. Apoptosis, 2010, 15(5): 631-638.
28.	Perez HE, Luna MJ, Rojas ML, et al. Chondroptosis: an immunohistochemical study of apoptosis and Golgi complex in chondrocytes from human osteoarthritic cartilage[J]. Apoptosis, 2005, 10(5): 1105-1110.
29.	Uchida K, Urabe K, Naruse K, et al. Hyperlipidemia and hyperinsulinemia in the spontaneous osteoarthritis mouse model, STR/Ort [J]. Exp Anita, 2009, 58(2): 181-187.
30.	Li S, Luo Q, Huang L, et al. Effects of pulsed electromagnetic fields on cartilage apoptosis signalling pathways in ovariectomised rats[J]. Int Orthop, 2011, 35: 1875-1882.
31.	Messier SP, Loeser RF, Miller GD, et al. Exercise and dictary weight loss in overweigt and obese older adults with knee osteoarthritis: the arthritis, diet and activity promotion tria1[J]. Arthritis Rheum, 2005, 50(4): 1501-1510.
32.	赵树信．温针灸治疗膝关节骨性关节炎[J]．中华现代临床医学杂志, 2005, 3(11): 1096．.
33.	肖建斌, 佘守章, 彭吕宪, 等．透明质酸钠联合消炎痛液注射治疗膝关节骨性关节炎的临床疗效观察[J]. 广东医学, 2006, 27(5): 210.
34.	陈作恒. 盐酸氨基葡萄糖与双氯芬酸钠治疗骨性关节炎疗效对比[J]. 吉林医学, 2012, 33(6): 1230.
35.	李敏, 杨南萍, 尉浩,等. 双醋瑞因联合盐酸氨基葡萄糖、双氯芬酸钠治疗骨性关节炎疗效比较 [J]. 华西医学, 2009, 24(8): 2067-2069.
36.	周广东, 苗春雷, 王晓云, 等．软骨细胞与骨髓基质细胞共培养体外软骨形成的实验研究[J]．中华医学杂志, 2004, 84(20): 1716-1720．.

1. 　Felson DT. Epidemiology of knee and hip osteoarthritis[J]．Epidemiol Rev, 1988, 10(8): 1-28.
2. 　Martin JA, Buckwalter JA. Aging, articular cartilage chondrocyte senescence and osteoarthritis[J]. Biogerontology, 2002, 3(5): 257-264．.
3. 　D’Ambrosia RD. Epidemiology of osteoarthritis[J]. Orthopedics, 2005, 28(Suppl 2): 201-205．.
4. 　Peixoto JG, Dias JM, Dias RC, et al. Relationships between measures of muscular performance, proprioceptive acuity, and aging in elderly women with knee osteoarthritis[J]. Arch Gerontol Geriatr, 2011, 53(2): 253-257.
5. 　Tanamas SK, Wijethilake P, WIuka AE, et al. Sex hormones and structural changes in osteoarthritis: a systematic review[J]. Maturitas, 2011, 69(2): 141-146.
6. 　薛延, 李东, 姚力, 等．雌激素受体等位基因多态性与骨关节炎的关系[J]．中华风湿病学杂志, 2004, 8(10): 583-586．.
7. 　庞璨, 贾伟平．脂肪组织缺氧与肥胖相关性炎症的研究现状[J]．中华医学杂志, 2008, 88(36): 2588-2591.
8. 　Jacobsen S, Sonne-Holm S, S balle K, et al. Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the osteoarthrosis sub-study of the copenhagen city heart study[J]. Acta Orthop, 2005, 76(2): 149-158．.
9. 　季锦飞, 戴进, 史冬泉, 等．遗传因素和机械因素与膝骨性关节炎发病年龄的关系[J]．中华医学遗传学杂志, 2010, 27(6)：672-674．.
10. 　Weiss E, Jurmain R. Osteoarthritis revisited: a contemporary review of aetiology [J]. Int J Osteoarchaeol, 2007, 17(5): 4372-4450.
11. 　Nakajima M, Miyamoto Y, Ikegawa S. Cloning and characterization of the osteoarthritis-associated gene DVWA[J]. J Bone Miner Metab, 2011, 29(3): 300-308．.
12. 　Li X, Gibson G, Kim JS, et al. MicroRNA-146a is linked to pain-related pathophysiology of osteoarthritis [J]. Gene, 2011, 3(21): 250-265.
13. 　Amiable N, Martel-Pelletier J. Lussier B, et al. Proteinase-activated receptor-2 gene disruption limits the effect of osteoarthritis on cartilage in mice：a novel target in joint degradation [J]. J Rheumatol, 2011, 38(5): 911-920.
14. 　Wang YH, Ni XH, Xu DW, et al. Expression of β-1, 4-galactosyl-transferase I in a surgically-induced rat model of knee osteoarthritic synovitis [J]. Chin Med J (Engl), 2010, 123(21): 3067-3073.
15. 　Santangelo KS, Pieczarka EM, Nuovo GJ, et al. Temporal expression and tissue distribution of interleukin-lt3 in two strains of guinea pigs with varying propensity for spontaneous knee osteoarthritis [J]. Osteoarthritis Cartilage, 2011, 19(4): 439-448.
16. 　Legendre F, Bogdanowicz P, Boumediene K, et al. Role of interleukin 6(IL-6)/IL-6R-induced signal tranducers and activators of transcription and mitogen-activated protein kinase [J]. J Rheumatol, 2005, 32(7): 1307-1316.
17. 　Kubo S, Cooper GM, Matsumoto T, et al. Blocking vascular endothelial growth factor with soluble Flt-1 improves the chondrogenic potential of mouse skeletal muscle-derived stem cells [J]. Arthritis Rheum, 2009, 60(1): 155-165.
18. 　Ekenstedt KJ, Sonntag WE, Loeser RF, et al. Effects of chronic growth hormone and insulin-like growth factor ideficiency on osteoarthritis severity in rat knee joints[J]. Arthriths Rheun, 2006, 54(12): 3850-3858.
19. 　周建林,刘世清,邱波.兔骨关节炎滑膜组织血管内皮生长因子mRNA表达及透明质酸钠的影响[J]. 中国组织工程研究与临床康复, 2010, 14(11): 1983-1986.
20. 　Yuan GH, Masuko-Hongo K, Kato T, et al. Immunologic intervention in the pathogenesis of osteoarthritis[J]．Arthritis Rheum, 2003, 48(3): 602-611.
21. 　Ley C, Ekman S, Ron6us B, et a1. Interleukin-6 and high mobility group box protein-1 in synovial membranes and osteochondral fragments in equine osteoarthritis[J]. Res Vet Sci, 2009, 86(3): 490-497.
22. 　Shen PC, Wu CL, Jou IM, et al. T helper cells promote disease progression of osteoarthritis by inducing macrophage inflammatory protein-1γ[J]. Osteoarthritis Cartilage, 2011, 19(6): 728-736.
23. 　Thomas CM, Fuller CJ, Whittles CE, et al. Chondrocyte death by apoptosis is associated with cartilage matrix degradation[J]. Osteoarthritis Caritlage, 2007, 15(1): 27-34.
24. 　Summers GC, Merrill A, Sharif M, et al. Swelling of articular cartilage depends on the integrity of adjacent cartilage and bone[J]. Biorheology, 2008, 45(3-4): 365-374.
25. 　Wei L, Sun X, Wang Z, et al. CD95-induced osteoarthritic chondrocyte apoptosis and necrosis：dependency on p38 mitogen-activated protein kinase[J]. Arthritis Res Ther, 2006, 8(2): 37.
26. 　Thomas CM, Whittles CE, Fuller CJ, et al. Variations in chondrocyte apoptosis may explain the increased prevalence of osteoarthritis in some joints[J]. Rheumatol Int (forthcoming), 2011(10): 1341-1348.
27. 　Almonte-Becerril M, Navarro-Garcia F, Gonzalez-Robles A, et al. Cell death of chondrocytes is a combination between apoptosis and autophagy during the pathogenesis of osteoarthritis within an experimental model[J]. Apoptosis, 2010, 15(5): 631-638.
28. 　Perez HE, Luna MJ, Rojas ML, et al. Chondroptosis: an immunohistochemical study of apoptosis and Golgi complex in chondrocytes from human osteoarthritic cartilage[J]. Apoptosis, 2005, 10(5): 1105-1110.
29. 　Uchida K, Urabe K, Naruse K, et al. Hyperlipidemia and hyperinsulinemia in the spontaneous osteoarthritis mouse model, STR/Ort [J]. Exp Anita, 2009, 58(2): 181-187.
30. 　Li S, Luo Q, Huang L, et al. Effects of pulsed electromagnetic fields on cartilage apoptosis signalling pathways in ovariectomised rats[J]. Int Orthop, 2011, 35: 1875-1882.
31. 　Messier SP, Loeser RF, Miller GD, et al. Exercise and dictary weight loss in overweigt and obese older adults with knee osteoarthritis: the arthritis, diet and activity promotion tria1[J]. Arthritis Rheum, 2005, 50(4): 1501-1510.
32. 　赵树信．温针灸治疗膝关节骨性关节炎[J]．中华现代临床医学杂志, 2005, 3(11): 1096．.
33. 　肖建斌, 佘守章, 彭吕宪, 等．透明质酸钠联合消炎痛液注射治疗膝关节骨性关节炎的临床疗效观察[J]. 广东医学, 2006, 27(5): 210.
34. 　陈作恒. 盐酸氨基葡萄糖与双氯芬酸钠治疗骨性关节炎疗效对比[J]. 吉林医学, 2012, 33(6): 1230.
35. 　李敏, 杨南萍, 尉浩,等. 双醋瑞因联合盐酸氨基葡萄糖、双氯芬酸钠治疗骨性关节炎疗效比较 [J]. 华西医学, 2009, 24(8): 2067-2069.
36. 　周广东, 苗春雷, 王晓云, 等．软骨细胞与骨髓基质细胞共培养体外软骨形成的实验研究[J]．中华医学杂志, 2004, 84(20): 1716-1720．.

West China Medical Journal

骨关节炎的发病机制及其诊治的研究进展

Abstract Full text Figures/Tables Video References Cited by

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