【摘要】 背景:实验显示双膦酸盐对预防股骨头塌陷起到积极作用,但临床应用结果存在一定争议,且由于系统用药的不良反应较多,近期对局部应用的研究逐渐增多。目的:综述双膦酸盐治疗股骨头缺血性坏死的研究进展。方法:由2位共同第一作者检索PubMed数据库及CNKI中国期刊全文数据库收录的双膦酸盐治疗股骨头缺血性坏死的相关文章,英文检索词为"osteonecrosis of the femoral head,bisphosphonates,systemic therapy,topical therapy,osteogenesis,bone destruction,bone remodeling",中文检索词为"股骨头坏死、双膦酸盐、系统、局部、成骨、破骨、骨重塑",按纳入和排除标准共纳入文献62篇进行归纳总结。结果与结论:双膦酸盐对成骨细胞既有抑制作用也有激活作用,目前存在一定争议。目前研究显示低浓度双膦酸盐可促进成骨细胞的增殖,而高浓度起到抑制作用。长期系统应用双膦酸盐会有下颌骨坏死等不良反应,而局部应用双膦酸盐治疗股骨头缺血性坏死仍停留在实验阶段,且治疗股骨头缺血性坏死的最佳浓度及药效持续时间都尚未确定,在临床应用前仍需进一步的高质量实验研究来阐明。更多还原

【Abstract】 BACKGROUND:Animal experiments have shown that bisphosphonates exhibit a preventive effect on femoral head collapse.However,clinical application of bisphosphonates remains disputed.Systematic administration of bisphosphonates has many adverse reactions.There is an increasing number of studies on local application of bisphosphonates.OBJECTIVE:To review the research progress of bisphosphonates in the treatment of avascular necrosis of the femoral head.METHODS:The first authors(GJC and MJH) searched PubMed and CNKI databases to retrieve papers regarding bisphosphonate treatment of osteonecrosis of the femoral head using the search terms "osteonecrosis of the femoral head,bisphosphonates,systemic therapy,topical therapy,osteogenesis,bone destruction,bone remodeling" in English and Chinese.Sixty-two eligible papers were included in the final analysis.RESULTS AND CONCLUSION:It remains disputed whether bisphosphonates inhibit or activate osteoblasts.Current studies have shown that low concentration of bisphosphonates can promote the proliferation of osteoblasts,while high concentration of bisphosphonates can inhibit the proliferation of osteoblasts.Long term systematic application of bisphosphonates can induce mandibular osteonecrosis and other side effects.Topical application of bisphosphonates for treatment of avascular necrosis of the femoral head is still in the experimental stage.The optimal bisphosphonate concentration and the duration of efficacy in the treatment of avascular necrosis of the femoral head have not been determined.These should be clarified by in-depth high-guality experiments prior to clinical application.更多还原