Sack K E
Program in Rheumatology, University of California, San Francisco (UCSF), School of Medicine 94143-0326, USA.
West J Med. 1995 Dec;163(6):579-86.
Osteoarthritis is a disorder of cartilage that affects almost 85% of the population by age 75. A lack of rigorous clinical and radiographic criteria for defining the disorder makes precise determination of its prevalence impossible. The process of wear and tear explains many manifestations of osteoarthritis, but it does not account for some of the clinical findings or the biochemical changes in osteoarthritic cartilage. Thus, other factors such as heredity, hormones, and diet may play a role. Treatment consists of teaching patients about their disease, alleviating pain, and preserving joint function. Nonsteroidal anti-inflammatory drugs may be no more effective than simple analgesics in relieving the pain of this disorder. Moreover, some nonsteroidal anti-inflammatory drugs can adversely affect cartilage metabolism, and most are possibly dangerous in elderly patients. Drugs that inhibit the production or activity of chondrolytic enzymes can slow the degeneration of cartilage in some animals, but their effects on humans with osteoarthritis are unproved. The surgical repair of severely damaged joints can have gratifying results.
骨关节炎是一种软骨疾病，到75岁时，几乎85%的人都会受到影响。由于缺乏严格的临床和影像学标准来定义这种疾病，因此无法精确确定其患病率。磨损过程解释了骨关节炎的许多表现，但它无法解释某些临床发现或骨关节炎软骨中的生化变化。因此，遗传、激素和饮食等其他因素可能也起到一定作用。治疗方法包括向患者介绍其病情、缓解疼痛以及保持关节功能。在缓解这种疾病的疼痛方面，非甾体抗炎药可能并不比简单的镇痛药更有效。此外，一些非甾体抗炎药可能会对软骨代谢产生不利影响，而且大多数对老年患者可能存在危险。抑制软骨溶解酶产生或活性的药物在一些动物身上可以减缓软骨退化，但它们对患骨关节炎的人类的影响尚未得到证实。对严重受损关节进行手术修复可能会取得令人满意的效果。
