摘要
目的系统评价唑来膦酸预防绝经妇女骨质疏松性骨折的效果。方法采用Cochrane系统评价方法,检索Cochrane图书馆、PubMed(1966年1月至2011年4月)、OVID(1993年1月至2011年4月)、EMBASE(1974年1月至2011年4月)、CNKI(1979年1月至2011年4月)、VIP(1989年1月至2011年4月)等数据库有关唑来膦酸盐与安慰剂降低绝经妇女骨质疏松性骨折风险的随机对照临床试验,随访2～3年且提供骨折发生率的文献纳入研究。评价入选文献的方法学质量,提取资料采用RevMan 5.0.25软件对纳入研究进行meta分析。结果共有3篇文献符合纳入标准,包括11 947名绝经期妇女骨质疏松患者。Meta分析结果显示唑来膦酸可降低75%的椎体骨折(RR=0.25,95%CI:0.18～0.36)、33%的髋部骨折(RR=0.67,95%CI:0.52～0.85)和24%非椎体非髋部骨折(RR=0.76,95%CI:0.67～0.87)的风险,差异有统计学意义(P均<0.05);唑来膦酸和安慰剂治疗后严重不良事件的发生率差异无统计学意义。结论每年注射5mg唑来膦酸可有效预防绝经妇女发生各种骨质疏松性骨折,且不增加严重不良事件发生率。
Objective To systematically analyze the studies investigating the outcomes of once-yearly administered intravenous zoledronic acid for preventing postmenopausal osteoporosis fracture.Methods Cochrane＇s systematic review methods were used to retrieve the randomized controlled trials（RCT） about decreasing the risks of osteoporosis fracture in postmenopausal women by zoledronic acid from Cochrane Library,PubMed（Jan.1966 to Apr.2011）,OVID（Jan.1993 to Apr.2011）,EMBASE（Jan.1974 to Apr.2011）,CNKI（Jan.1979 to Apr.2011）,and VIP（Jan.1989 to Apr.2011） database.The studies were limited to human studies including bone fracture rates and follow-up for 2-3 years.All literatures identified from the data sources were evaluated for review inclusion,and the methodology of the included literatures was evaluated.Meta-analysis was performed using RevMan 5.0.25 software.Results Three randomized controlled studies met the inclusion criteria,including a total of 11 947 postmenopausal women with osteoporosis.Meta analysis results showed that zoledronic acid could reduce clinical vertebral fractures,hip fractures and nonvertebral-nonhip fractures by 75%（RR=0.25,95%CI： 0.18-0.36）,33%（RR=0.67,95%CI： 0.52-0.85）,and 24%（RR=0.76,95%CI： 0.67-0.87）,respectively（P0.05 for all comparisons）.The incidence rates of serious adverse events were not significantly different between zoledronic acid group and placebo group.Conclusion Once-yearly intravenous injection of zoledronic acid（5 mg） can effectively prevent osteoporosis fracture in postmenopausal women without increasing the risk of serious adverse events.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2011年第9期985-990,共6页
Academic Journal of Second Military Medical University
关键词
唑来膦酸
绝经后骨质疏松
META分析
骨折
zoledronic acid
postmenopausal osteoporosis
meta analysis
bone fractures
