类风湿性关节炎（RA）骨代谢紊乱可导致骨密度降低及骨脆性增加，一方面可能是由于疾病本身的炎症环境及免疫异常引起，另一方面糖皮质激素等药物的干预也可能加重骨质疏松的发生。RA骨代谢紊乱随着病程进展及炎症反应呈进行性加重，早期可表现有关节软骨破坏及骨端骨质疏松，晚期可累及四肢、腰椎的骨密度降低脆性增加，甚至全身性骨质疏松的发生。明确RA骨破坏特点对RA骨代谢紊乱的诊断及针对性防治具有重要作用，对改善风湿病患者的生活质量及疾病控制具有重要意义。综述了近年RA骨代谢异常及药物干预相关研究进展，首先从骨代谢紊乱的发病率、累及的不同骨组织以及可能发病机制对RA骨代谢紊乱的表现进行了总结，在此基础上从缓解RA病情药物、生物制剂以及中医药防治RA骨代谢紊乱作用进行了药物干预现状的总结，以期为RA骨破坏的治疗提供一定参考。

Rheumatoid Arthritis (RA) related bone metabolism disorders could lead to decreased bone density and increased bone fragility. It may be caused by the of the RA disease related inflammatory environment and immune abnormalities, on the other hand, the intervention of drugs, such as glucocorticoids, may also increase the occurrence of osteoporosis. RA related bone metabolism disorders is progressively aggravated with the progression of the disease and the inflammatory response. In the early stage, it can show the destruction of articular cartilage and osteoporosis. In the late stage, the bone density of the limbs and lumbar spine can be reduced, even the occurrence of systemic osteoporosis. To clarify the characteristics of RA bone destruction would play an important role in the diagnosis and treatment of RA bone metabolism disorders, and it would be of great significance in improving the quality of life and disease control of RA patients. Therefore, this review summarized the recent research progress of RA bone abnormalities and drug intervention. The incidence of bone metabolic disorders, the different bone tissues involved, the possible pathogenesis of bone metabolic disorders and the intervention effect of drugs are summarized in order to provide some clues for the treatment of RA related bone metabolism disorders.

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