双膦酸盐类(bisphosphonates,BPs)在临床上广泛应用于预防和治疗骨质疏松症等疾病,取得了良好的治疗效果,但大量报道指出其可通过抗血管生成及抑制骨吸收等作用引发药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ).MRONJ是一种严重的不良反应,根据剂量和使用时间的不同,这种药物不良反应可能很少发生(如口服双膦酸盐治疗骨质疏松症),也可能经常发生(如静脉注射双膦酸盐治疗癌症).当前导致颌骨坏死的病理机制尚未完全明确,针对MRONJ的诊治也未形成统一共识,本文通过整理归纳近年来有关MRONJ的发病机制及临床治疗等相关问题研究结果,叙述现国内外研究进展,为临床应用研究工作提供指导和帮助.
Research and Progress of Bisphosphonates Medication-related Osteonecrosis of the Jaw
Bisphosphonates(BPs)is clinical widely used in the prevention and treatment of osteoporosis and other diseases,and have achieved good therapeutic effect.However,a large number of reports have pointed out that BPs often cause medication-related osteonecrosis of the jaw(MRONJ)through anti-angiogenesis and inhibiting bone resorption.MRONJ is a serious adverse effect that may occur infrequently(e.g.following the oral administration of bisphosphonate treatments for osteoporosis)or frequently(e.g.following intravenous bisphosphonate for cancer treatment),depending on the dose and duration of use.At present,the pathological mechanism leading to jaw necrosis has not been fully clarified,and no consensus has been reached on the diagnosis and treatment of MRONJ.This paper summarized the research results on the pathogenesis and clinical treatment of MRONJ in recent years,and described the current research progress at home and abroad,to provide guidance and help for clinical application research.
BisphosphonateOsteonecrosis of jawBone resorptionDiagnostic criteriaPathogenesis
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