特立帕肽治疗骨质疏松合并腰椎退行性变经椎间融合后骨融合率的系统评价  被引量:3

Systematical evaluation of bone fusion rate after interbody fusion in patients with osteoporosis and lumbar degenerative disease treated with teriparatide

在线阅读下载全文

作  者:蒋晓成 石璐 王胤斌 李秋江 席创珍 马泽丰 蔡利军 Jiang Xiaocheng;Shi Lu;Wang Yinbin;Li Qiujiang;Xi Chuangzhen;Ma Zefeng;Cai Lijun(Third Clinical Medical College of Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,Ningxia Hui Autonomous Region,China)

机构地区:[1]宁夏医科大学第三临床医学院,宁夏回族自治区银川市750004 [2]宁夏医科大学,宁夏回族自治区银川市750004 [3]宁夏回族自治区人民医院,宁夏回族自治区银川市750002

出  处:《中国组织工程研究》2023年第9期1427-1433,共7页Chinese Journal of Tissue Engineering Research

摘  要:目的:系统评价特立帕肽治疗骨质疏松合并腰椎退行性变患者经椎间融合后骨融合率的变化。方法:全面检索PubMed、Embase、Cochrane library、Home-ClinicalTrials(美国临床试验数据库)、中国知网、万方、维普、中国生物医学文献服务系统、中国临床试验数据库等,以“teriparatide,spinal fusion,spondylodesis,randomized controlled tria,randomized、placebo”为英文检索词,以“特立帕肽,脊柱融合,腰椎融合,椎间融合”为中文检索词。检索时间为各数据库建库至2021-11-16。收集骨质疏松合并腰椎退行性疾病患者经腰椎椎间融合术后应用特立帕肽的随机对照试验。采用Cochrane评价手册进行文献方法学质量分析。主要结局指标为骨融合率、椎弓根螺钉松动的人数、椎弓根螺钉松动的数量,次要结局指标为术后12个月的腰痛功能障碍指数评分。采用RevMan 5.3和Stata 16.0软件进行Meta分析。结果:(1)共纳入9篇高质量研究文献,包括536例患者;(2)Meta分析结果显示,特立帕肽组在随访6个月时较对照组能显著增加骨融合率[RR=1.96,95%CI(1.38-2.80),Z=3.73,P=0.0002<0.05],而在随访12个月时骨融合率与对照组无明显差异[RR=1.02,95%CI(0.88-1.17),Z=0.23,P=0.82>0.05],提示特立帕肽能提高骨质疏松合并腰椎退行性疾病患者经椎间融合术后的骨融合率且能缩短骨融合时间;(3)在随访12个月,特立帕肽组与对照组相比能显著降低椎弓根螺钉的松动率(P<0.05);(4)特立帕肽组与利塞膦酸组在椎弓根螺钉松动的人数上无显著差异[RR=0.99,95%CI(0.58-1.70),Z=0.02,P=0.98>0.05],但是特立帕肽组与利塞膦酸组相比可以降低椎弓根螺钉松动的数量,且差异有显著性意义[RR=0.50,95%CI(0.32-0.78),Z=3.05,P=0.002<0.05]。结论:(1)特立帕肽可促进骨融合并缩短骨融合时间;(2)特立帕肽能降低椎弓根螺钉松动的发生率;(3)特立帕肽对术后腰痛功能障碍指数评分的影响尚不能明确。OBJECTIVE:To systematically review the changes of bone fusion rate after interbody fusion in patients with osteoporosis and lumbar degenerative disease treated with teriparatide.METHODS:A comprehensive search of PubMed,Embase,Cochrane library,Home-ClinicalTrials(US clinical trial database),CNKI,Wanfang,VIP,Chinese Biomedical Literature Service System and Chinese clinical trial database was performed with"teriparatide,spinal fusion,spondylodesis,randomized controlled trial,randomized,placebo"as English search terms and"te ri para tide,spinal fusion,lumbar fusion,interbody fusion"as Chinese search terms.The search time was from database establishment to November 16,2021.All randomized controlled trials of teriparatide after lumbar fusion in patients with osteopo rosis and lumbar degeneration we re collected.The methodological quality of the literature was analyzed using the Cochrane Review Manual.Primary outcome measures were the rate of bone fusion,the number of patients with pedicle screw loosening,and the rate of pedicle screw loosening.Secondary outcome measure was the Oswestry Disability Index score for low back pain at 12-month follow-up.Meta-analysis was performed using RevMan 5.3 and Stata 16.0 software.RESULTS:(1)A total of 9 high-quality research articles were included,including 536 patients.(2)Meta-analysis results showed that bone fusion rate was significantly increased in the teriparatide group compared with the control group at 6-month follow-up[RR=1.96,95%C/(1.38-2.80),Z=3.73,P=0.0002<0.05],but there was no significant difference in bone fusion rate between teriparatide group and control group at 12-month follow-up[RR=1.02,95%CI(0.88-1.17),Z=0.23,P=0.82>0.05],suggesting that teriparatide can improve postoperative bone fusion rate and shorten bone fusion time in osteoporotic patients with lumbar degenerative diseases.(3)At a follow-up time of 12 months,the loosening rate of pedicle screws in the teriparatide group was significantly lower than that in the control group(P<0.05).(4)There was no significa

关 键 词:特立帕肽 骨质疏松 腰椎融合 椎间融合术 Meta分析 随机对照试验 

分 类 号:R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象