双膦酸盐与骨折愈合和非典型性骨折

摘要

Fracture healing is typically characterized by four overlapping stages that include the hematoma and inflammatory response, initial fibrocartilage callus formation, hard callus formation and bone remodeling.The remodeling process is driven by a coupled process of bone resorption and bone formation.The soft callus remodeling and hard callus remodeling are of great importance to fracture healing.Bisphosphonates act to affect fracture healing by intervening callus remodelling, based on its pharmacological action of inhibiting the osteoclast activity and bone turnover level.Long-term use of bisphosphonates does not favor the fracture healing, and has been associated with the possibility of atypical fracture of the femur.%典型的骨折愈合过程包括血肿和炎症反应、原始软骨痂形成、成熟板层骨形成以及骨板重建和塑形等4个时期.骨重建包括骨吸收和骨形成两个方面.软骨痂和硬骨痂重建对骨折愈合具有重要意义.双膦酸盐类药理基础在于抑制破骨细胞活性和骨转化水平,通过干预骨重建对骨折愈合产生影响.长期使用双膦酸盐不利于骨折愈合,有引起股骨非典型性骨折发生的危险.