预防性服用阿仑膦酸钠降低绝经后妇女骨折风险的Meta分析  

Alendronate for osteoporotic fractures prophylacsis in postmenopausal women： a meta-analysis

作　　者：王新玲[1] 姜东[1] 吕新胜[1] 

机构地区：[1]新疆克拉玛依市中心医院CT科,834000

出　　处：《中华老年医学杂志》2013年第10期1128-1132,共5页Chinese Journal of Geriatrics

摘　　要：目的系统评价阿仑膦酸钠对绝经后妇女骨质疏松性骨折的一级预防和二级预防的作用。方法按照Cochrane系统评价的方法，计算机检索美国国立生物医学信息中心Pubmed医学数据库、荷兰医学文摘Embase数据库、Cochrane图书馆临床对照试验数据库（2011年第2期）、中国生物医学文献数据库（CBM）、中文科技期刊全文数据库（CNKI）、万方及维普数据库，并检索所纳入文献的参考文献。收集所有相关随机对照试验，采用Cochrane协作网提供的软件RevMan5．0进行Meta分析。结果共纳入11项随机对照试验进行评价。Meta分析结果显示，就二级预防而言，每天服用10mg阿仑膦酸钠对减少脊椎、髋、腕部骨折发生率有统计学意义（RR=0．57，95％（71：0．49～0．67）；但就一级预防而言，除减少椎体骨折的发生有统计学意义外（RR=0．55，95％CI：0．38～0．80），未发现减少其他骨折有统计学意义。与阿仑膦酸钠相关的不良反应无增加，敏感性分析结果无改变（RR=0．95，95％CI：0．83～1．09）。结论阿仑膦酸钠的二级预防能减少绝经后妇女骨质疏松性骨折的发生，仍需对一级预防的疗效进行大样本研究。Objective To systematically evaluate the efficacy of alendronate on the primary and secondary preventions of osteoporotic fractures in postmenopausal women. Methods Literatures and related references were searched from MEDLINE （from 1966 to April 2011）, Embase （from 1966 to April 2011）, Cochrane Library （the second Issue, 2011） , CBM disc, CNKI, WANFANG and VIP database by Cochrane systematical evaluation. All related randomized controlled trials were collected, and Meta analysis was performed by RevMan 5.0 soft ware provided by Cochrane collaboration. Results Totally 11 randomized controlled trials were evaluated. Meta-analysis showed that 10 mg oral alendronate daily for secondary prevention could reduce the incidence of spine, hip, wrist and non vertebra fractures （RR--0.57, 95%CI： 0.4%0.67）, but for the primary prevention, alendronate could not reduce the fracture incidence except for spine fracture （RR 0.55, 95~ CI.. O. 38-0.80）. Adverse events associated with alendronate were not increased, and the sensitivity analysis results were not changed （RR 0.95, 95~ CI： 0.83-1.09 ） . Conclusions Alendronate can reduce osteoporotic fractures in postmenopausal women for the secondary prevention, but the effect of alendronate on osteoporotic fractures for the primary prevention needs further study.

关 键 词：骨质疏松 绝经后 骨折 系统评价 

分 类 号：R580[医药卫生—内分泌]