不同因素影响激素性股骨头坏死家兔模型成模效果的网状Meta分析  

Network meta-analysis of the modeling effects of different factors on rabbit models of steroid-induced osteonecrosis of femoral head

作　　者：胡智星 李群 杨超 王潇潇 方罗昌婷 侯吴琼 林娜[2] 陈卫衡 刘春芳[2] 林雅[1] Hu Zhixing;Li Qun;Yang Chao;Wang Xiaoxiao;Fang Luochangting;Hou Wuqiong;Lin Na;Chen Weiheng;Liu Chunfang;Lin Ya(College of Pharmacy,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian Province,China;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China;Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]福建中医药大学药学院,福建省福州市350122 [2]中国中医科学院中药研究所,北京市100700 [3]北京中医药大学第三附属医院,北京市100029

出　　处：《中国组织工程研究》2024年第6期976-984,共9页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金重点项目(82030122),项目负责人:陈卫衡;国家自然科学基金面上项目(81973888),项目负责人:陈卫衡;北京市自然科学基金面上项目(7232304),项目负责人:刘春芳;中央级公益性科研院所基本科研业务费专项(ZXKT20013),项目负责人:刘春芳;中国中医科学院科技创新工程项目(C12021A03808),项目负责人:林娜。

摘　　要：目的:激素性股骨头坏死家兔模型是最常用的股骨头坏死动物模型,其股骨头病理学改变与临床较为接近,但目前国内外报道的造模条件、方法和评价标准等均不统一,导致所建立动物模型的科学价值低、难于推广应用。此次研究旨在明确不同造模条件对激素性股骨头坏死家兔模型建立的影响,分析模型成功建立的适宜条件。方法:检索中国知网、万方、维普、中国生物医学文献服务系统、Web of Science、PubMed和EMbase数据库中截至2022-04-01前有关激素性股骨头坏死家兔造模的文献,依据纳排标准以及文献质量评价等完成对文献的筛选并提取文献中结局指标数据,运用RevMan、Stata和ADDIS统计软件对纳入数据进行Meta分析。结果:(1)最终纳入82篇文献,共1366只家兔纳入研究,激素性股骨头坏死造模方法分为单纯激素法、激素联合脂多糖法和激素联合血清法3种,其中单纯激素法33篇文献,激素联合脂多糖法20篇文献,激素联合血清法29篇文献;(2)Meta分析结果显示,3种造模方法均能显著增加激素性股骨头坏死家兔股骨头空骨陷窝率(P<0.001),显著降低激素性股骨头坏死家兔股骨头骨小梁面积比(P<0.001);各造模方法的空骨陷窝率排序结果为:激素联合脂多糖法>单纯激素法>激素联合血清法>正常组;骨小梁面积比排序结果:正常组>激素联合血清法>单纯激素法>激素联合脂多糖法;(3)亚组分析结果提示:单纯激素诱导的家兔模型空骨陷窝率可能与家兔品种和造模用激素种类有关(组间差异P<0.05),其中新西兰白兔合并效应量高于中国白兔(P<0.05)和日本白兔,地塞米松合并效应量高于其他激素种类;激素联合脂多糖诱导的模型空骨陷窝率与激素种类和脂多糖给药模式有关(组间差异P<0.05),其中甲泼尼龙琥珀酸钠合并效应量显著高于其他激素种类(P<0.05),泼尼松龙合并效应量显著低于其他激素种类(P<OBJECTIVE:The rabbit model of steroid-induced osteonecrosis of femoral head is the most commonly used animal model of femoral head necrosis.The pathological changes of the femoral head are close to clinical practice,however,the conditions,methods and evaluation standards of animal models reported in and outside China are not uniform,which leads to the low scientific value of animal models and is difficult to popularize.This study aimed to clarify the influence of different mold-making conditions on the establishment of steroid-induced osteonecrosis of femoral head rabbit model and analyze the appropriate conditions for the successful model establishment.METHODS:We searched the CNKI,WanFang,VIP,CBM,WoS,PubMed and EMbsae databases for the literature on the modeling of steroid-induced osteonecrosis of femoral head rabbits up to April 1,2022,completed the screening of the literature according to the inclusion and exclusion criteria and literature quality evaluation,and extracted the outcome index data in the literature.RevMan Stata and ADDIS statistical software were used to conduct a meta-analysis of the included data.RESULTS:(1)A total of 82 articles with 1366 rabbits were included in the study.The steroid-induced osteonecrosis of femoral head modeling methods were divided into three types:steroid-alone method,steroid combined lipopolysaccharide method and steroid combined serum method.Among these,33 articles used steroid-alone method;20 articles used steroid combined lipopolysaccharide method;29 articles used steroid combined serum method.(2)Meta-analysis results showed that the three modeling methods significantly increased the rate of empty bone lacunae in the femoral head of steroid-induced osteonecrosis of femoral head rabbits(P<0.001),and significantly decreased the ratio of the trabecular bone area in the femoral head of steroid-induced osteonecrosis of femoral head rabbits(P<0.001).The order of empty bone lacunae rate of each modeling method was:steroid combined with lipopolysaccharide method>steroid-alone

关 键 词：激素性股骨头坏死 家兔 动物模型 造模方法 影响因素 亚组分析 网状Meta分析 循证医学 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R-332