双膦酸盐类药物相关颌骨坏死发病机制及治疗研究进展

摘要

双膦酸盐类药物相关颌骨坏死是双膦酸盐类药物一种潜在的严重副反应，发生率从0到28％不等。以患者出现缺血性骨坏死和骨暴露为典型特征，伴有明显疼痛、颌面部瘘管、甚至病理性骨折，极大地影响患者的生活质量和相关的治疗。其发病因素涉及药物本身的药理作用、创伤因素、感染因素、以及可能的致病基因带来的易感性，发病机制较为复杂。该病的治疗方法种类较多，包括全身使用抗生素、局部冲洗和含漱、手术治疗、高压氧舱、激光、自体骨髓干细胞移植等，但无一能够达到非常有效的治疗效果。本文就双膦酸盐类药物相关颌骨坏死的发病机制、临床治疗的相关研究进展进行文献综述。%Recent reports have described osteonecrosis of the jaw bones as a potentially serious complication related to the long-term use of bisphosphonates, and the incidence ranges from 0 to 28%.The bisphosphonate-related osteonecrosis of the jaws ( BRONJ) is characterized by ischemic osteonecrosis and bone exposure, and is accompanied with sever pain, fistula, and pathological fractures, which immensely influences the quality of patients ’ life and the related treatment.The pathogenesis of BRONJ is complex and still remains uncertain, which may include the pharmacological action of drugs, trauma, infection, and the susceptibility casued by possible genes.There are various treatments for BRONJ, including general use of antibiotics, local wash, mouthwash, operation treatment, hyperbaric oxygen chamber treatment, laser, and autologus bone marrow stem cell transplantation, but no one has satisfied therapeutic efficacy.This paper reviews the research progress of the pathogenesis and treatment of BRONJ.