利噻膦酸钠治疗绝经期妇女骨质疏松症疗效的Meta分析  

Meta-analysis of Therapeutic Efficacy of Risedronate for Osteoporosis in Menopausal Women

作　　者：韦侃侃[1] 朱泓霞 王雪锋 

机构地区：[1]郑州大学第四附属医院药学部,郑州450044 [2]余姚市第二人民医院,浙江余姚315400

出　　处：《中国药房》2014年第36期3400-3403,共4页China Pharmacy

摘　　要：目的:系统评价利噻膦酸钠治疗绝经期妇女骨质疏松症的临床疗效,以为临床提供循证参考。方法:计算机检索The Cochrane Library、PubMed、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库,收集利噻膦酸钠治疗绝经期妇女骨质疏松症的随机对照试验(RCT),提取资料后采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入14项RCT,合计1 372名患者。Meta分析结果显示,试验组患者有效率[RR=1.77,95%CI(1.57,2.00),P<0.000]、腰椎骨密度[MD=4.51,95%CI(3.62,5.41),P<0.000]、髋骨骨密度[MD=1.84,95%CI(1.24,2.44),P<0.000]显著高于对照组,血清骨钙素水平[MD=-1.89,95%CI(-2.07,-1.72),P<0.01]、血钙水平[MD=-0.04,95%CI(-0.08,-0.01),P<0.01]、碱性磷酸酶水平[MD=-11.08,95%CI(-15.24,-6.91),P<0.01]、尿I型胶原交联氨基末端肽与肌酐比值[MD=-27.97,95%CI(-44.50,-11.44),P<0.01]显著低于对照组,两组比较差异均有统计学意义。结论:利噻膦酸钠治疗绝经期妇女骨质疏松症疗效较好,可以防止绝经后妇女的骨丢失,降低骨转换,改善骨密度。由于文献存在漏检可能,研究方法报道不详尽,期待今后国内研究更加注重对研究方法学的报道,以提高研究报道质量。OBJECTIVE：To evaluate the therapeutic efficacy of risedronate for osteoporosis in menopausal women systematically,and to provide evidence-based reference for clinical use. METHODS：Retrieved from The Cochrane Library,PubMed,CBM,CNKI,VIP and Wangfang database,RCTs about risedronate in the treatment of osteoporosis in menopausal women were collected.Meta-analysis of included trials was performed using Rev Man 5.2 software. RESULTS：A total of 14 RCTs were included,involving 1 372 patients. Meta-analysis showed that the effective rate [RR=1.77,95%CI（1.57,2.00）,P〈0.01],lumbar vertebra BMD[MD=4.51,95%CI（3.62,5.41）,P〈0.01] and innominatum BMD [MD=1.84,95%CI（1.24,2.44）,P〈0.01] of trial group were significantly higher than those of control group,while serum osteocalcin [MD=-1.89,95%CI（-2.07,-1.72）,P〈0.01],blood calcium [MD=-0.04,95%CI（-0.08,-0.01）,P〈0.05],ALP [MD=-11.08,95%CI（-15.24,-6.91）,P〈0.01],NTX/Cr[MD=-27.97,95%CI（-44.50,-11.44）,P〈0.01] of trial group were significantly lower than those of control group;there was statistical significance. CONCLUSIONS：Risedronate exerts positive effects on osteoporosis in menopausal women in China,can prevent bone loss,reduce bone turnover and improve BMD. Due to small-scale and low-quality included studies,the conclusion should be further validated by more large-scale and high-quality RCTs.

关 键 词：利噻膦酸钠 绝经期妇女骨质疏松症 有效性 META分析 

分 类 号：R977[医药卫生—药品]