颌骨坏死的血管相关发病机制与治疗进展

doi:10.13701/j.cnki.kqyxyj.2025.02.001

摘要/Abstract

摘要： 颌骨坏死是拔牙、损伤、放化疗后累及颌骨的一种常见的口腔疾病,包括放射性颌骨坏死和药物性颌骨坏死,主要表现为骨质暴露、疼痛、感染,以及病理性骨折等。颌骨坏死的发病机制具有多种假说,其中血管的异常改变是重要机制之一。辐射通过损伤内皮细胞并形成血液高凝状态促进血栓形成,成为放射性颌骨坏死的关键环节。血管生成抑制在药物性颌骨坏死的发生和发展中起重要作用,涉及巨噬细胞、内皮细胞、前破骨细胞等多种细胞及其分泌的细胞因子。促进血管生成能缓解或治疗颌骨坏死,调节血管功能有望成为治疗颌骨坏死的新方案。本文综述了颌骨坏死的血管相关发病机制,并探索其在开发颌骨坏死新治疗策略中的潜在应用。

关键词: 放射性颌骨坏死, 血栓形成, 药物性颌骨坏死, 血管生成抑制, 治疗策略

Abstract: Osteonecrosis of the jaw is a common oral disease involving the jaw after tooth extraction, injury, and radiotherapy, including osteoradionecrosis and medication-related osteonecrosis of the jaw. Its main clinical manifestations are bone exposure, pain, infection, and pathological fracture. The pathogenesis of osteonecrosis of the jaw involves various hypotheses, among which vascular abnormalities are one of the essential mechanisms. Radiation promotes thrombosis by damaging endothelial cells and creating a hypercoagulable state of blood, which becomes a key link in the initiation of osteoradionecrosis of the jaw. Angiogenesis inhibition plays an important role in the development of medication-related osteonecrosis of jaw and is associated with a variety of cells such as macrophages, endothelial cells, preosteoclasts, and their secreted cytokines. Promoting angiogenesis can alleviate or treat osteonecrosis of the jaw. Regulation of vascular function is expected to be a therapeutic option for osteonecrosis of the jaw. This article reviews the vascular-related pathogenesis of osteonecrosis of the jaw and explores potential applications for therapeutic strategies.

Key words: osteoradionecrosis of the jaw, thrombosis, medication-related osteonecrosis of the jaw, angiogenesis inhibition, therapeutic strategies

石易鑫, 陈俊宇. 颌骨坏死的血管相关发病机制与治疗进展[J]. 口腔医学研究, 2025, 41(2): 85-89.

SHI Yixin, CHEN Junyu. Vascularization-related Pathogenesis and Treatment Progress of Osteonecrosis of the Jaw[J]. Journal of Oral Science Research, 2025, 41(2): 85-89.

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