传统改善病情的抗风湿药对骨代谢的影响

摘要

传统改善病情的抗风湿药(cDMARD)是治疗风湿性疾病的常用药物.研究表明,不同的cDMARD对骨代谢的影响也不同,如来氟米特和羟氯喹可抑制破骨、减少骨丢失,而环磷酰胺促进破骨、加重骨丢失,低剂量甲氨蝶呤一般不会对类风湿关节炎患者骨密度造成影响.骨代谢异常是风湿性疾病患者的常见表现,临床医师应了解cDMARD对骨代谢的影响.为此,该文就cDMARD对风湿性疾病患者骨代谢的潜在作用和相关机制进行综述,旨在为临床实践和科学研究提供参考.%Conventional disease-modifying anti-rheumatic drug (cDMARD) are widely used in the treatment of rheumatic diseases.Previous studies have demonstrated that different cDMARD exert varying effects upon bone metabolism.For instance,leflunomide and hydroxychloroquine can inhibit bone injury and decrease bone loss.Cyclophosphamide can accelerate bone injury and aggravate bone loss.Low dose of methotrexate exerts no effect upon the bone density of patients diagnosed with rheumatoid arthritis.Abnormal bone metabolism is one of the common symptoms of rheumatic diseases.Clinicians should be aware of the effect of cDMARD on bone metabolism.Hence,the potential role and underlying mechanism of cDMARD on the bone metabolism of patients with rheumatic diseases were summarized in this article,aiming to provide reference for relevant scientific research and clinical practice.