与类固醇和酒精使用相关的骨髓缩 - - 病变发生的最新情况
Wojciech Konarski1, Tomasz Poboży1, Klaudia Konarska2
1Department of Orthopaedic Surgery, Ciechanów Hospital, 06-400 Ciechanów, Poland.
Healthcare (Basel, Switzerland)
|July 14, 2023
概括
过度饮酒和使用皮质类固醇显著增加了骨髓缩 (ON) 的风险,这是一种使人虚弱的骨疾病. 限制摄入和使用对于预防和管理这种情况至关重要.
科学领域:
- 骨生物学和疾病
- 骨髓缩的病理生理学
- 酒精和皮质类固醇的毒性影响.
背景情况:
- 骨髓缩 (ON) 是一种导致严重残疾的渐进性疾病,通常影响30-50岁的个体.
- 非创伤性骨髓硬化经常与滥用酒精和使用皮质类固醇有关,在多达80%的病例中涉及.
- 了解酒精和类固醇诱导的ON背后的机制对于患者管理至关重要.
研究的目的:
- 审查和综合有关酒精和皮质类固醇对骨健康影响的当前数据.
- 阐明导致这些药物导致骨髓缩的病理生理过程.
- 为预防和管理提供基于证据的建议.
主要方法:
- 进行现有研究的叙述性审查.
- 在EMBASE和MEDLINE数据库中进行文献搜索.
- 综合了剂量和时间依赖的风险和共享的病原遗传机制的研究结果.
主要成果:
- 酒精和皮质类固醇的使用都显示了骨髓缩的时间和剂量相关风险.
- 共享的病原遗传途径包括增加脂肪生成,慢性炎症,血管变化和骨细胞分化受损.
- 酒精和类固醇诱导的ON通常呈现为多焦点性疾病.
结论:
- 滥用酒精和过度使用皮质类固醇是骨髓缩的显著可改变的危险因素.
- 医生应建议患者限制乙醇摄入量,避免过度使用皮质类固醇.
- 对于被诊断为ON的患者,建议治疗成和减少使用类固醇.
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