文档介绍：透明质酸在运动医学中的应用
 
摘要透明质酸(hyaluronic acid, HA)是一种独特的线性黏多糖,广泛分布于人体各组织的细胞外基质中,具有很强的亲水性和高度的黏弹性。HA是关节滑液的主要成分,由滑膜细胞、成纤维细胞和软骨细胞分泌,在保护关节软骨中起着重要作用。目前,HA已广泛应用于运动医学领域、特别是骨关节炎治疗,同时也被用于关节扭伤、冻结肩和肩袖损伤等疾病治疗。本文就HA的理化特性及其在运动医学中的应用情况作一综述。  关键词透明质酸运动医学骨关节炎冻结肩肩袖损伤  :; R982 :A :1006-1533(2012)15-0012-05  Application of hyaluronic acid in sports medicine  SHANG Xi-liang?, CHEN Shi-yi, LI Yun-xia??  (Huashan Hospital affiliated to Fudan University, Shanghai 200040, China)  ABSTRACT Hyaluronic acid (HA) is a unique linear haride atrix of human tissues and has strong hydrophilicity and high viscoelasticity. HA is the major chemical ponent of synovial fluid, secreted by synovial cells, fibroblasts and chondrocytes, edicine, especially in the treatment of osteoarthritis. In addition, the efficacy of HA has been recently demonstrated in the treatment of joint sprains, frozen shoulder, rotator cuff lesion, etc. Aim of the present paper is to summarize the physicochemical properties of HA and its applications in sports medicine.  KEY eta分析以比较关节腔内注射HA和糖皮质激素治疗膝关节OA的疗效后发现,1~4周内糖皮质激素控制疼痛症状的效果较好、4周时两药疗效相当、8周后则HA更有效,表明尽管HA缓解疼痛的作用出现较晚,但持续时间却较糖皮质激素长。根据X线检查OA的Kellgren-Lawrence(K-L)分类[11],发现HA最适宜用于治疗K-L分类
Ⅱ~Ⅲ级的膝关节OA患者;对严重OA(K-L分类Ⅳ级)、关节间隙明显狭窄、有严重骨硬化和畸形、多发较大骨赘或关节功能有明显障碍患者,尽管关节腔内注射HA能缓解部分症状,但对关节功能改善无明显效果。不过,若患者不能耐受其他治疗方法时,为缓解症状,亦可采用HA治疗。对K-L分类Ⅰ级患者、特别是有关节软骨损伤者,目前多主张早期应用关节腔内注射HA。医药  其他关节OA  与膝关节OA相比,目前关节腔内注射H