[1]付海瑞,杨露阳,梁斌,等.抗骨吸收药对骨修复的影响：一项随机对照研究的系统综述和meta分析[J].中华老年骨科与康复电子杂志,2022,(01):35-43.[doi:10.3877/cma.j.issn.2096-0263.2022.01.007]
　Fu Hairui,Yang Luyang,Liang Bin,et al.Effect of anti-resorptive agents affect on bone repair. A meta-analysis of randomized controlled studies[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(01):35-43.[doi:10.3877/cma.j.issn.2096-0263.2022.01.007]
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抗骨吸收药对骨修复的影响：一项随机对照研究的系统综述和meta分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2022年01期
页码:
35-43
栏目:
Meta分析
出版日期:
2022-02-05

文章信息/Info

Title:
Effect of anti-resorptive agents affect on bone repair. A meta-analysis of randomized controlled studies
作者:
付海瑞1; 3; 杨露阳2; 梁斌3; 刘强1
030032 山西省太原市山西医科大学附属白求恩医院骨科1；030001 山西省太原市山西医科大学第一医院内分泌科2；032200 山西省吕梁市汾阳市山西医科大学附属汾阳医院骨科3
Author(s):
Fu Hairui1; 3;  Yang Luyang2;  Liang Bin3;  Liu Qiang1
1Department of Orthopedics, Affiliated Bethune Hospital of Shanxi Medical University, Taiyuan 030032, China; 2Endocrinology Department, The First Hospital of Shanxi Medical University, Taiyuan 030001, China; 3Department of Orthopedics, Affiliated Fenyang Hospital of Shanxi Medical University, Fenyang 032200, China
关键词:
抗骨吸收药;  骨连接;  脊柱融合;  骨折愈合;  meta分析
Keywords:
The anti-resorptive drugs;  Bone union;  Spinal fusion;  Fracture healing;  Meta-analysis
DOI:
10.3877/cma.j.issn.2096-0263.2022.01.007
文献标志码:
A
摘要:
目的 旨在明确骨修复的炎症期或骨生成期使用抗骨吸收药是否会影响骨修复。方法 检索MEDLINE， EMBASE，CENTRAL和中国生物医学文献数据库，检索时间为自建库至2020年12月19日。研究的纳入标准为使用抗骨吸收药与骨修复关系的所有相关临床随机对照研究。纳入研究的质量评价使用5.2版本的Cochrane偏倚风险评估工具，使用Review Manager 5.4.1软件进行数据合成。其中，使用风险比（RR）及其95%的置信区间（CI）作为效应量，使用Mantel-Haenszel法和固定效应模型进行分析。结果 最终确认符合纳入标准的相关研究25个，有18个研究纳入meta分析，包含3 421例，合成的骨连接RR=1.013（95% CI：0.994，1.032，P=0.198）。敏感性分析中，排除11个非低风险研究后的骨连接RR=1.008（95% CI：0.987，1.029，P=0.475）。亚组分析中，四肢骨折愈合人群（9个研究，2 891例）的骨连接RR=1.009（95% CI：0.989，1.029，P=0.399）；脊柱融合人群（9个研究，530例）的骨连接RR=1.034（95% CI：0.979，1.091，P=0.230）；骨质疏松患者人群（13个研究，749例）的骨连接RR=1.038（95% CI：0.993，1.086，P=0.103）；内固定手术人群（15个研究，2 967例）的骨连接RR=1.005（95% CI：0.989，1.021，P=0.540）。各研究结果均包括无效值1，即骨修复早期使用抗骨吸收药不影响骨连接。结论 通过该研究可见，在骨修复的炎症期或骨生成期应用抗骨吸收药并不影响骨连接。其中，无论四肢骨折患者或脊柱融合手术患者，无论骨质疏松患者，或经历内固定手术患者，在骨修复早期应用抗骨吸收药预防继发性骨质疏松性骨折均不影响骨连接。因此，对于适用抗骨质疏松治疗的患者，出现骨折后建议立即开始抗骨质疏松治疗。
Abstract:
Objective The meta-analysis was performed to determine whether the early use of the anti-resorptive drugs would affect bone union. Methods We searched MEDLINE, EMBASE, CENTRAL and CBM for the related studies from each database inception until December 19, 2020. The inclusion criteria were all relevant clinical randomized controlled studies that studied the relationship between the anti-resorptive drugs and bone union. We assessed the quality of the included studies with version 5.2 of the Cochrane risk-of-bias tool, and the software for data synthesis was Review Manager 5.4.1. The effect measure was risk ratio (RR) with 95% confidence interval (CI), the Mantel-Haenszel method and the fixed effect model were used to analyze data. Results 25 studies met the inclusion criteria, 18 studies were included in the meta- analysis, including 3, 421 people, the total bone union RR=1.013(95% CI: 0.994, 1.032, P=0.198). In the sensitivity analysis of excluding 11 non-low-risk studies, RR=1.008 (95% CI: 0.987, 1.029, P=0.475). In the subgroup analysis, the limb fracture population(9 studies, 2, 891 persons), RR= 1.009 (95% CI: 0.989, 1.029, P=0.399); the spinal fusion population (9 studies, 530 persons), RR=1.034 (95% CI: 0.979, 1.091, P=0.230), the osteoporotic population (13 studies, 749 persons), RR=1.038 (95% CI: 0.993, 1.086, P=0.103); the internal fixation surgery population (15 studies, 2,967 persons), RR=1.005 (95% CI: 0.989, 1.021, P=0.540). The results of each analysis included an invalid value of 1, that is, the early use of the anti-resorptive drugs in bone repair did not affect bone union. Conclusions In general, the early application of the anti-resorptive drugs in bone repair does not affect bone union. Among them, no matter the limb fracture patients or the spinal fusion patients, whether the osteoporotic patients, or the patients undergoing internal fixation surgery, the use of the anti-resorptive drugs in the early stage of bone repair to prevent secondary osteoporosis fracture does not affect bone union. Therefore, for patients suitable for anti-osteoporosis treatment, it is recommended to start anti-osteoporosis treatment immediately after fracture.
更新日期/Last Update: 2022-04-25