单独补充维生素D与维生素D结合钙防治中老年骨质疏松性骨折的系统评价

发布时间：2018-05-14 09:51

本文选题：骨质疏松性骨折 + 维生素D　；参考：《广西医科大学》2015年硕士论文

【摘要】：目的：对单独补充维生素D与结合补充维生素D和钙与安慰剂和钙剂对比预防中老年骨质疏松性骨折的疗效进行系统评价。方法：计算机检索Cochrane协作网数据库(1992-2014年12月份),MEDLINE(1992-2014年12月份),EMBASE(1992-2014年12月份)、中国生物医学文献数据库(CBM,1992-2014年12月份)、中文期刊全文数据库(CNKI,1992-2014年12月份)。手工检索国内期刊已发表的论文和会议资料,收集所有相关随机对照试验,并评价纳入研究的方法学质量。统计软件使用Cochrane协作网提供的RevMan5.3结果：计算机检索到相关文献81篇,最终纳入24个随机对照试验(RCT),包括141047例患者。Meta分析结果：1、关于死亡率治疗组与对照组对比的死亡率无统计学意义,其中维生素D结合钙组与对照组分析结果：RR=1.24(95%CI=0.91-1.70,P=0.18)；维生素D组与对照组分析结果：RR=1.05(95%CI=0.97-1.13,P=0.27)；2、关于骨折发生率单纯维生素D组与对照组的发生率无明显优势：RR=0.97(95%CI=0.89-1.04,P=0.38)；维生素D结合钙组与对照组的发生率有统计学差异：RR=0.90(95%CI=0.82-0.98,P=0.02)；3、关于血清25羟基维生素D浓度治疗组的血清25羟基维生素D浓度明显比对照组提高。结论：单独补充维生素D和结合维生素D和钙与对照组对比的死亡率没有区别；血清25羟基维生素D浓度通过治疗虽然改善但还没达到骨健康状态；单独补充维生素D预防骨质疏松性骨折无明显优势；维生素D结合钙可降低骨质疏松性骨折的发生率。
[Abstract]:Aim: to evaluate the efficacy of vitamin D alone and calcium supplementation with placebo and calcium in the prevention of osteoporotic fractures in middle-aged and old people. Methods: a computer search was conducted on the Cochrane collaborative network database in December 1992 to December 2014, and the Chinese Biomedical Literature Database (CBM) in December 1992 to December 2014, and the full text Database of Chinese Journals from 1992 to December 2014. Manual retrieval of published papers and conference materials in domestic journals, collection of all relevant randomized controlled trials, and evaluation of methodological quality included in the study. The statistical software uses the RevMan5.3 results provided by the Cochrane Cooperative Network: 81 related papers were retrieved by computer. Finally, 24 randomized controlled trials were conducted, including 141047 patients. Meta-analysis results showed that there was no significant difference in mortality rate between the treatment group and the control group. The results of vitamin D combined calcium group and control group were 0.91-1.70 P0. 18; vitamin D group and control group showed 0. 97-1. 13 pectin 0.270.The incidence of fracture in vitamin D alone group and control group were not significantly superior to that in control group. There was no significant difference between vitamin D group and control group in the incidence of bone fracture; vitamin D combined calcium group and the control group. The incidence rate of the control group was significantly different. The serum 25 hydroxyvitamin D concentration in the treatment group was significantly higher than that in the control group. Conclusion: there is no difference between the mortality of vitamin D supplementation alone and combined vitamin D and calcium compared with the control group, the concentration of 25 hydroxyvitamin D in serum has not reached the state of bone health although it has been improved by treatment. Vitamin D supplementation alone has no significant advantage in preventing osteoporotic fractures, but vitamin D combined calcium can reduce the incidence of osteoporotic fractures.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580;R687.3

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