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透明質酸是什麼?


透明質酸是什麼?

透明質酸, 或稱玻尿酸、琉璃醣碳基酸 是一種糖胺聚醣,在人體內自然存在的物質,它的透明質子能帶 500 倍以子的水分。它的分佈廣泛,特別是以高濃度模式混和在滑膜液中(關節液)。它也是存在於皮膚、神經和各種結締組織。


透明質酸在關節的作用是什麼?

透明質酸是滑膜液的主要成分。它能增加滑膜液的粘度,並促進它的潤滑功能。它也是關節軟骨的重要組成部分,便軟骨留住水份,來產生其抗壓縮的特性。


在骨關節炎中透明質酸的醫療用途是什麼?

當關節有炎症時,滑膜液內的成分退化,失去了他們的粘黏度和潤滑作用。透明質酸是滑膜液的主要組成部分。往關節腔內注射透明質酸,能產生viscosupplementation的作用 ,試圖潤滑關節和減少痛楚。關節腔內注射透明質酸治療膝關節炎症已經被美國 FDA 批准作為治療處方的一種方式。透明質酸是也可用以口服形式補充,但效果是不那麼直接。


透明質酸是有用嗎?

研究的結果是好壞參半。雖然一些研究支持關節內注射透明質酸的療效,有幾個星期到幾個月,能減少疼痛;也有其他研究表明注射的效果不明顯,與安慰劑沒有區別。

在一般情況下,相信它可能會對早期階段的關節炎提供短期的止痛效果。然而,它不能停止或扭轉關節炎的進程。對於晚期的骨性關節炎,由於軟骨的損耗嚴重,影響可能微乎其微。


它是使用透明質酸安全嗎?

一般设有很嚴重的副作用。也許在注射的部位有一點疼痛;也有病者可能對透明質酸有過敏的反應,特別是以口服形式的。嚴重的副作用如關節感注射後染後或心血管意外事件,是相當罕見的。



What is hyaluronic acid?


What is hyaluronic acid?

Hyaluronic acid is a glycosaminoglycan,  a substance that is naturally present in human body.  Its molecule  can hold over  500 times of water. It is widely distributed, with especially high concentration in synovial fluid (joint fluid).  It is also present in various connective tissues, skin and nerves.


What is the function of hyaluronic acid in joints?

Hyaluronic acid is a major component of synovial fluid. It increases fluid viscosity, and is responsible for its lubricating function.

It is also an important component of articular cartilage. It helps to maintain water inside cartilage, and is responsible for its resistance to compression.


What is the medical use of hyaluronic acid in osteoarthritis?

In osteoarthritis, the components inside synovial fluid degenerate, losing their viscosity and lubricating function. As hyaluronic acid is a major component of synovial fluid, it is used as viscosupplementation by intra-articular injection, in an attempt to improve lubrication and decrease pain. Intra-articular injection of knee joint has been approved by FDA in USA. Hyaluronic acid is also available in an oral supplement form, but the effect is less direct.


Is hyaluronic acid useful?

Results of researches are mixed. While some researches support the efficacy of intra-articular hyaluronic acid injection in reducing pain for weeks to months, other researches show no difference. In general, it is believed that it may provide a temporary pain relief in early stage of osteoarthritis. However, it cannot halt or reverse the progress of osteoarthritis. In advanced stage of osteoarthritis with significant loss of cartilage, the effect is probably minimal.


Is it safe to use hyaluronic acid?

In general there are not much severe side effects. There maybe pain at the site of injection. There may also be allergic reaction especially with oral forms. More severe side effects include joint infection after an injection or cardiovascular events, but these are quite rare.

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