轴性脊柱关节炎骨损失的发病,评估和管理
Akihiro Nakamura1, Tanveer Towheed1
1Department of Medicine, Division of Rheumatology, Queen's University, Kingston, Ontario, Canada; Translational Institute of Medicine, School of Medicine, Queen's University, Ontario, Canada; Kingston Health Science Centre, Kingston, Ontario, Canada.
Seminars in arthritis and rheumatism
|December 16, 2023
概括
轴性脊柱关节炎 (axSpA) 涉及骨损失和骨的形成. 了解其机制,早期评估骨变化,并采用量身定制的管理策略,对于患者护理至关重要.
科学领域:
- 风湿病学和骨质新陈代谢
- 炎症性关节病是一种炎症性关节病.
背景情况:
- 轴性脊柱关节炎 (axSpA) 的特点是同时发生新的骨形成和椎骨损失.
- axSpA中的骨动力学是复杂的,受炎症,机械压力和肠道微生物群的影响.
研究的目的:
- 审查 axSpA.骨损失的病原性.
- 探索 axSpA.骨变化的评估方法.
- 讨论 axSpA 骨损失的潜在管理策略.
主要方法:
- 叙事文学评论. 叙事文学评论. 叙事文学评论. 叙事文学评论.
- 探索 axSpA 相关的骨损失的致病性,评估和管理.
主要成果:
- axSpA中的骨损失是由炎症,机械压力和肠道微生物群驱动的,通过RANK-RANKL和Wnt信号传递等途径影响骨质细胞和骨质细胞活动.
- 建议早期评估骨变化.
- 像TBS,QCT和QUS这样的高级成像显示出希望,但缺乏常规整合;DXA可能会高估骨密度.
- 管理包括抗炎药物和生活方式的改变,个性化干预是关键.
结论:
- 骨损失是axSpA的一个关键特征,需要定期评估和综合管理.
- 多学科的方法是至关重要的,因为有助于 axSpA.骨损失的复杂因素.
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