本文介紹骨性關節炎基礎醫學之探討,內容包括,一、概述,二、流行病學的研究,三、病理變化。 骨性關節炎在分類上是屬風濕性疾患的一種。它幷非是一種必然發生的老化現象,可能是長時期暴露在會造成某些病態生理變化的因素中,而在年紀老大時才表現出來。骨性關節炎在老年族群中,會造成明顯的殘障比例。近來,許多治療方法,已經可以有效的解决病人的症狀和恢復日常生活或工作的能力。 在各不同族群,大於35歲的人口中,骨性關節炎的盛行率約為60%。隨著年齡的增長,有明顯的增加趨勢。大於55歲的人口中,女性患者明顯的多於男性。性別也影響受犯關節的分佈型式。機械性因子、全身性因子、種族、遺傳以及發炎反應等和骨性關節炎的關連均有探討。 在病理變化的早期,最先可見關節軟骨的退化。在中期,由於顫動式切割(Fibri-llation)、水平切割和軟骨磨損,造成鈣化組織暴露於關節面。晚期,可見關節下硬骨的硬化現象(Osteosclerosis),有空囊散置其間,而且有新生的織維組織和類軟骨組織,産生修補作用。
This article introduces the basic considerations of osteoarthritis. It contains three parts: 1. the introduction 2. the epidemiologic study 3. the pathologic change. Osteoarthritis is a subset of the rheumatic disorders. It is not an inevitable event of aging, but is likely the result of prolonged exposure to pathophysiologic processes that occur much earlier in life. Although the majority of OA patients in younger age groups may have mild symptoms, OA will result in severe disability in older populations. Recent advances in treating OA have made it much effectively in relieving symptoms and restoring the living or working abilities of patients. The prevalence rate of OA in any population over 35 y/o is about 60%. The rate was found significantly increased with advancing age. The disease occurs much frequently in women over 45 y/o. Sex also influences the pattern of distribution of OA. Mechanical factors, systemic factors, ethnic groups, heredity and inflammation were discussed regarding their relationship with OA. Cartilage degeneration is a common feature in preclinical stage of OA. Fibrillation, horizotal splitting and cartilage thinning from grinding damage in intermediate stage will further expose the calcified tissure and lead to late stage. In late stage OA, osteosclerosis of the subarticular bone with some interspersed cysts were striking pictures. Plugs of new fibrous and chondroid tissures interspersed over the exposured bone will play an important role in remodeling and repairing activities.