双膦酸盐预防脑卒中及帕金森病老年患者髋部骨折疗效的Meta分析

发布时间：2018-07-11 10:00

本文选题：髋部骨折 + 双膦酸盐　；参考：《安徽医科大学》2015年硕士论文

【摘要】：研究背景及目的:脑卒中和帕金森病导致肢体功能残疾和活动受限,并增加患者出现继发髋部骨折的风险。本研究的目的是比较3种不同的双膦酸盐类药物,在预防合并神经系统疾病的高龄患者发生髋部骨折的疗效。材料与方法:文献检索主要在MEDLINE,EMBASE,中国生物医学文献数据库和Cochrane图书馆中进行,截止日期是2014年3月1日,文献采用严格的随机对照试验(RCT),并进行了一项Meta分析。每一个随机对照研究采用Jadad量表评价。八项随机对照试验包括5个脑卒中后患者使用双膦酸盐预防骨折发生的随机对照试验以及3个帕金森病患者使用双膦酸盐预防骨折发生的随机对照试验,均符合文献纳入标准要求。结果:双膦酸盐类药物治疗髋部骨折与对照组进行对比,相对风险(95%可信区间)分别为0.20(0.07-0.54,脑卒中组)和0.26(0.13-0.52,帕金森病组)。总体来说,总的相对风险为0.24(0.14-0.42)。研究结果显示,在2组合并神经系统疾病的老年人群中,相对于对照组,使用双膦酸盐可以使髋部骨折的风险明显降低。同时,与安慰剂组相比,使用双膦酸盐类药物治疗后,骨密度值、甲状旁腺激素、1,25-二羟维生素D数值均增加,而血清钙离子浓度及尿脱氧吡啶啉数值均减少。结论:数据显示,使用双膦酸盐类药物无严重不良事件的报告。一项基于随机对照研究的严格的Meta分析结果表明,在合并脑卒中和帕金森病的老年患者中应用双膦酸盐预防髋部骨折是有效的。
[Abstract]:Background and objective: stroke and Parkinson's disease lead to limb disability and limited movement, and increase the risk of secondary hip fractures. The aim of this study was to compare the efficacy of three different bisphosphonates in the prevention of hip fractures in elderly patients with neurological diseases. Materials and methods: literature retrieval was conducted in MEDLINE EMBASE, Chinese Biomedical Literature Database and Cochrane Library. The deadline was March 1, 2014. The literature was conducted with a strict randomized controlled trial (RCT) and a meta-analysis was performed. Each randomized controlled study was evaluated with Jadad scale. Eight randomized controlled trials included five randomized controlled trials in which bisphosphonates were used to prevent fractures after stroke and three randomized controlled trials in which patients with Parkinson's disease used bisphosphonates to prevent fracture. All meet the requirements of literature inclusion standards. Results: compared with the control group, the relative risk (95% CI) was 0.20 (0.07-0.54, stroke group) and 0.26 (0.13-0.52, Parkinson's disease group) respectively. Overall, the total relative risk is 0.24 (0.14-0.42). The results showed that the use of bisphosphonates significantly reduced the risk of hip fractures in two groups of elderly people with neurological disease compared with the control group. At the same time, compared with the placebo group, the bone mineral density, parathyroid hormone (PTH) and dihydroxyvitamin D increased, but the serum calcium concentration and urine deoxypyridinoline decreased after treatment with bisphosphonates. Conclusion: the data showed that no serious adverse events were reported in the use of bisphosphonates. A rigorous meta-analysis based on a randomized controlled study showed that bisphosphonates were effective in preventing hip fractures in elderly patients with stroke and Parkinson's disease.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R743.3;R742.5

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