中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (39): 7345-7349.doi: 10.3969/j.issn.2095-4344.2012.39.026

• 骨与关节学术探讨 academic discussion of the bone and joint • 上一篇    下一篇

创伤后的关节挛缩

卢国强   

  1. 三峡大学仁和医院，湖北省宜昌市 443001
  • 收稿日期:2012-06-04 修回日期:2012-07-13 出版日期:2012-09-23 发布日期:2012-09-23
  • 作者简介:卢国强，男，1962年生，汉族，1984年三峡大学毕业，主任医师，主要从事骨创伤、脊柱方面的研究。 yc117193@163.com

Post-trauma contracture of joints

Lu Guo-qiang   

  1. Renhe Hospital of China Three Gorges University, Yichang 443001, Hubei Province, China
  • Received:2012-06-04 Revised:2012-07-13 Online:2012-09-23 Published:2012-09-23
  • About author:Lu Guo-qiang, Chief physician, Renhe Hospital of China Three Gorges University, Yichang 443001, Hubei Province, China yc117193@163.com

PDF

386

被引次数

4

摘要：

背景：关节挛缩是创伤治疗中的难题，关节挛缩一旦发生，常导致终生功能障碍。目前的研究表明，关节挛缩发生的关键部位在于关节滑膜，滑膜组织的纤维化是关节挛缩发生的主要原因。早期的研究表明转化生长因子β在肺、肝、肾及皮肤的纤维化中具有关键性作用。但在关节挛缩发生过程中的作用及其机制尚不清。
目的：总结并讨论关节挛缩发生过程中各因素的作用及其机制。
方法：由第一作者用计算机检索中国期刊全文数据库(CNKI：2000/2010)和Medline(2000/2010)数据库，检索词分别为“创伤，关节挛缩”和“joint contracture，synovium，fixation，transforming growth factor-β1”。从关节挛缩的形态变化，细胞因子的作用及细胞因子间的相互关系等方面进行总结，对关节挛缩发生中的形态学改变及其调节机制等方面进行介绍。共检索到196篇文章，按纳入和排除标准对文献进行筛选，共纳入39篇文章。
结果与结论：关节滑膜组织的纤维化是关节挛缩发生的生物学基础，包括转化生长因子β、结缔组织生长因子、α-平滑肌肌动蛋白、基质金属蛋白酶和金属蛋白酶组织抑制剂等多种细胞及细胞因子参与其发生过程，转化生长因子β是关节挛缩发生核心因子。目前研究对机械作用对于转化生长因子β的调控作用机制尚不完全清楚，因此时间对挛缩程度的影响作用程度有待于进一步研究。

关键词: 转化生长因子β1, 关节挛缩, 滑膜, 胶原, 创伤, 数字化骨科, 组织工程

Abstract:

BACKGROUND: Joint contracture is a difficult problem in the trauma treatment. Joint contracture during the treatment of joint trauma often results in lifelong dysfunction. The present study shows that joint contractures often occur in the synovium, and synovial tissue fibrosis is the main reason for the joint contractures. Previous studies suggest that transforming growth factor β plays a key role in the lung, liver, kidney and skin fibrosis, but the effect of transforming growth factor β in joint contracture is not clear.
OBJECTIVE: To review the effect and mechanism of the factors in joint contraction.
METHODS: The CNKI database and Medline database (2000/2010) were searched by the first author with the key words of “trauma, joint contracture” in Chinese and “joint contracture, synovium, fixation, transforming growth factor-β1” in English. We reviewed from the morphological changes of the joint contracture, the effect of the cytokines and the interaction of cytokines. We introduced from the aspects of morphological changes and the regulation mechanism in joint contracture. A total of 196 articles were obtained, and 39 articles were included according to the exclusion and inclusion criteria.
RESULTS AND CONCLUSION: Joint synovial tissue fibrosis is the biological basis of joint contractures, the cells and cytokines including transforming growth factor β, connective tissue growth factor, a-smooth muscle actin, matrix metalloproteinase and metalloproteinase tissue inhibitors participate in process of fibrosis, and transforming growth factor β is the center factors of the joint contracture. The mechanical effect on the regulation mechanism of transforming growth factor β is unclear, so the effect of time on the degree of joint contracture needs further study.

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