双膦酸盐对骨质疏松症患者腰椎融合影响的系统评价和Meta分析

发布时间：2018-02-04 10:33

本文关键词： 双膦酸盐骨质疏松症腰椎融合 Meta分析　出处：《中国骨质疏松杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的通过Meta分析系统评价双膦酸盐对骨质疏松症患者腰椎融合的影响。方法系统检索Pub Med、Science Direct、Google Scholar、CNKI、VIP和Wan Fang Data自建库以来到2017年1月的文献,运用Stata11.0定量分析纳入的文献。结果最终有9篇研究符合纳入标准,Meta分析结果显示:双膦酸盐组与对照组的对比中,植骨融合情况[RR=1.138,95%CI(1.064,1.217)]、终末随访骨密度T值[MD=0.038,95%CI(0.025,0.052)]、ODI指数[MD=-4.36,95%CI(-6.372,-2.348)]、骨吸收生化标志物CTX值[MD=-0.401,95%CI(-0.511,-0.291)]、VAS评分[MD=0.940,95%CI(0.548,1.332)]之间差异均有统计学意义(P0.01);终末随访术后骨形成生化标志物PINP值[MD=-4.328,95%CI(-8.954,0.298)]、不良反应情况[RR=0.725,95%CI(0.420,1.251)]之间差异无统计学意义(P=0.067和P=0.248)。结论腰椎术后应用双膦酸盐并不影响骨质疏松症患者的骨融合结果,而且通过治疗能有效抑制骨吸收代谢,改善其骨量和术后功能恢复程度,且与对照组安全性相近。
[Abstract]:Objective to evaluate the effect of bisphosphonates on lumbar fusion in patients with osteoporosis by Meta analysis system. The literatures of Google Scholarus, VIP and Wan Fang Data have been published since January 2017. Stata11.0 quantitative analysis was used to analyze the literature included. Results in the end, 9 studies were in accordance with the inclusion criteria. The results of Meta-analysis showed that the bone graft fusion in the bisphosphonate group was compared with that in the control group. [The bone mineral density (BMD) T value was followed up at the end of the follow-up. [MDN 0.038 / 95 CIQ 0.025 / 0.052) / ODI index. [CTX value of bone resorption biochemical marker (MD-4.36 + 95% CIQ -6.372U -2.348). [MD-0.401 / 95 CIQ -0.511 ~ -0.291)] VAS score. [There were significant differences between MD0.94095 CII 0.548 and 1.332). PINP value of biochemical markers of bone formation after final follow-up was significant (P < 0.01). [MDN 4.32895 CIQ -8.954 0.298), adverse reactions. [RRN 0.725 / 95 CI 0.420. There was no significant difference between the two groups. Conclusion the results of bone fusion in patients with osteoporosis were not affected by the application of bisphosphonates after lumbar surgery. In addition, the treatment can effectively inhibit bone resorption and metabolism, improve the bone mass and the degree of functional recovery after operation, and the safety is similar to that of the control group.
【作者单位】：广西中医药大学第一附属医院;广西中医药大学研究生学院;
【分类号】：R580;R687.3
【正文快照】： 腰椎融合内固定术是脊柱外科治疗脊柱退变性疾病最常用的手术。年龄相关性的形态学上的改变和椎体、椎间盘复合物多种力学应力的改变可轻易导致腰椎的不稳和畸形,融合内固定术可提供足够的稳定性及良好的复位,从而实现更短的住院时间和早期的恢复。而退行性脊柱疾病往往伴随骨

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