中文摘要：

背景：关于股骨头坏死的发病机制国内外学者提出了各种学说：血运障碍、脂质代谢紊乱、骨内压增高、骨细胞凋亡、基因多态性、免疫因素等,但其具体发病机制仍不明确.目的：就股骨头坏死的发病机制研究进展作一综述,以期为研究股骨头坏死的学者提供线索.方法：以＂femoral head necrosis,osteonecrosis of femoral head,pathogenesis,mechanism＂检索词在Pubmed、Embase、Medline等数据库检索1985至2017年的文献;以＂股骨头坏死＂、＂发病机制＂为检索词检索中国知网、万方及维普1985至2017年的文献,最终纳入39篇文献进行回顾性分析.结果与结论：股骨头坏死是多种因素共同作用导致的复杂疾病,生物力学因素在其发生发展过程中发挥重要作用.股骨头内部力学性能的减退或者各种危险因素导致的外界应力与股骨头内部结构不协调,引起内部骨小梁的微骨折,应力集中,反复破坏与修复,当破坏速度超过修复速度,股骨头最终发生塌陷.大部分股骨头坏死病例均为散发病例,但也有研究报道家族中多名成员患有特发性股骨头坏死,呈家族聚集性,股骨头坏死可能和遗传因素有关联.

英文摘要：

BACKGROUND： Theories concerning the pathogenesis of osteonecrosis of the femoral head （ONFH） are various, such as blood supply dysfunction, lipid metabolism disorder, increased intraosseous pressure, osteocyte apoptosis, gene polymorphism and immunity, but the underlying mechanisms remain unclear.OBJECTIVE： To review the pathogenesis of ONFH, thus providing clues for the study on ONFH.METHODS： Search strategy ＂femoral head necrosis OR osteonecrosis of femoral head AND pathogenesis OR mechanism＂ was used to search articles published between 1985 to 2017 in PubMed, Embase, and Medline databases.Meanwhile, CNKI, WanFang and VIP databases were searched with Chinese keywords of ＂femoral head necrosis,pathogenesis＂ from 1985 to 2017. Finally, 39 articles were included for retrospective analysis.RESULTS AND CONCLUSION： ONFH is a complex disease caused by a variety of factors, among which, biomechanics plays an important role in its occurrence and development. The internal mechanic strength of the femoral head is reduced or the imbalance between external stress and inner structures of femoral head caused by various risk factors leads to micro-fractures of the trabeculae, stress concentration and repeated destruction and repair. When the destruction rate exceeds the repair speed, the femoral heads eventually collapse. Most of ONFH cases are sporadic, but its familial aggregation has been reported; therefore, it may be related with genetic factor.