Bone Microstructure in Osteoporosis: Transilial Biopsy and Histomorphometry
Bone Microstructure in Osteoporosis: Transilial Biopsy and Histomorphometry
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DOI：
10.1097/00002142-200210000-00002
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发表时间：
2002-10
影响因子：
--
通讯作者：
M. Barger-Lux;R. Recker
中科院分区：
文献类型：
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作者：
M. Barger-Lux;R. Recker
骨质疏松症的骨脆性不能完全用骨量不足来解释。经尿道骨活检的组织形态学检查已经确定了微观结构缺陷，根据已知的结构材料的机械特性，这些缺陷进一步损害了骨强度。组织形态学测量描述了活检标本，其小梁在空间中的配置，以及其小梁晶格完好无损的程度。绝经后患有骨质疏松症的妇女，皮质骨和松质骨缺乏症是典型的，即皮质骨厚度和松质骨体积往往大大减少。大部分松质骨缺损可归因于整个骨小梁构件的缺失，而不是骨小梁的广泛性变薄。小梁连通性的直接测量证实了这一印象：骨质疏松症的妇女比健康妇女有更少的小梁淋巴结和更多的末端，即使在相同的松质骨体积。经尿道活检中积累的微损伤的证据是间接的，这种现象本身很可能局限于骨折部位。经尿道活检的组织形态学数据包含了大量关于骨质疏松症的结构和功能特征的信息，并提供了有关新治疗对骨微观结构影响的有价值的信息。
The bone fragility of osteoporosis is not fully explained by a deficit in bone mass. Histomorphometric examination of transilial bone biopsies has identified microstructural defects that—in light of what is known about the mechanical properties of structural materials—further compromise bone strength. Histomorphometric measures describe the biopsy specimen, the configuration of its trabeculae in space, and the extent to which its trabecular lattice is intact. In postmenopausal women with established osteoporosis, a deficit of both cortical and cancellous bone is typical, i.e., both cortical thickness and cancellous bone volume tend to be substantially reduced. Much of the cancellous bone deficit can be attributed to loss of entire trabecular elements rather than to generalized thinning of trabeculae. Direct measures of trabecular connectivity confirm this impression: women with established osteoporosis have fewer trabecular nodes and more termini than healthy women, even at the same cancellous bone volume. Evidence for accumulated microdamage in transilial biopsies is circumstantial, and the phenomenon itself may well be localized to fracture sites. Histomorphometric data from transilial biopsies comprise a large body of information about the structural and functional character of osteoporosis and provide valuable information about the effects of new treatments on bone microstructure.