药物相关性颌骨坏死的研究进展

发布时间：2019-06-10 09:00

【摘要】：随着抗骨吸收和抗血管生成药物的不断使用,药物相关性颌骨坏死作为一种较严重的不良反应受到广泛关注。药物相关性颌骨坏死属于多因素影响的疾病,危险因素众多,在一般人群中的年发病率大致为每年1×10-5。目前存在多种假说解释有关机制。双膦酸盐和狄诺塞麦能抑制破骨细胞的分化及功能,促进破骨细胞凋亡,使骨吸收及骨重建减少。双膦酸盐的抗血管生成作用降低了颌骨区域血供,同时抑制了机体的免疫功能。口腔局部的菌群还会进一步加重组织损伤和减少血管生成。除此之外,双膦酸盐对口腔黏膜细胞的直接作用和颌骨的解剖结构都对骨坏死的发展有一定的作用。患者的治疗措施因患病情况存在差异,但均以减轻痛苦、控制软硬组织感染、延缓或停止骨坏死进程为主。本文就药物相关性颌骨坏死的危险因素、相关机制、分期以及预防治疗策略作一综述。
[Abstract]:With the continuous use of anti-bone resorption and antiangiogenic drugs, drug-associated jaw necrosis has been widely concerned as a serious adverse reaction. Drug-associated jaw necrosis is a multifactorial disease with many risk factors. The annual incidence rate in the general population is about 1 脳 10 ~ (- 5) per year. At present, there are many hypotheses to explain the relevant mechanisms. Bisphosphonate and Dinosemer can inhibit the differentiation and function of osteoclasts, promote osteoclast apoptosis, and reduce bone resorption and bone reconstruction. The antiangiogenic effect of bisphosphonate decreased the blood supply of jaw region and inhibited the immune function of the body. Local oral flora will also further aggravate tissue injury and reduce angiogenesis. In addition, the direct effect of bisphosphonate on oral mucous membrane cells and the anatomical structure of jaw play a certain role in the development of osteonecrosis. The treatment measures of the patients were different because of the illness, but the main treatment measures were to alleviate the pain, control the infection of soft and hard tissue, and delay or stop the process of osteonecrosis. In this paper, the risk factors, related mechanisms, staging and preventive and therapeutic strategies of drug-associated jaw necrosis were reviewed.
【作者单位】：口腔疾病研究国家重点实验室华西口腔医院种植科(四川大学);
【基金】：国际口腔种植学会基金(973_2014)~~
【分类号】：R782

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