唑来膦酸联合经皮穿刺椎体后凸成形术治疗骨质疏松性椎体压缩骨折临床疗效的Meta分析  

Meta-analysis of Clinical Efficacy of Zoledronic Acid Combined with Percutaneous Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures

作　　者：崔宁宁 穆春梅 王文 杜跃 高海睿 刘泽 康凯[3] 冯俏[2] CUI Ning-ning;MU Chun-mei;WANG Wen;DU Yue;GAO Hai-rui;LIU Ze;KANG Kai;FENG Qiao(Department of Medicine,Tianjin University,Tianjin 300072,,China;Medical College of Yan'an University,Yan'an 716000,Shaanxi,China;Department of Orthopedics,Affiliated Hospital of Yan'an University,Yan'an 716000,Shaanxi,China)

机构地区：[1]天津大学医学部,天津300072 [2]延安大学医学院,陕西延安716000 [3]延安大学附属医院骨科,陕西延安716000

出　　处：《医学信息》2023年第20期53-57,共5页Journal of Medical Information

基　　金：陕西省高等教育学会2021年高等教育科学研究项目(编号:XGH21133);延安大学教学改革研究项目(编号:YDJGYB21-04);延安大学校级科研项目(编号:YDQ2019-37);延安大学大学生创新创业训练计划项目(编号:D2020153)。

摘　　要：目的系统评价唑来膦酸联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效和安全性。方法计算机检索中国知网(CNKI)、Cochrane图书馆、PubMed数据库中有关唑来膦酸联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的随机对照试验(RCT),时限为建库至2021年10月。根据统一的纳入、排除标准筛选文献,评价原始数据,Cochrane偏倚风险评估工具评价RCT的研究质量,采用RevMan 5.4软件进行Meta分析。结果共纳入研究9篇,合计995例受试者。Meta分析显示,治疗组骨密度值大于对照组[MD=0.05,95%CI(0.03,0.07),P<0.0001];治疗组术后骨折再发生率小于对照组[OR=0.13,95%CI(0.06,0.26),P<0.00001];治疗组VAS评分低于对照组[MD=-0.96,95%CI(-1.51,-0.40),P=0.0007];治疗组ODI得分低于对照组[MD=-5.58,95%CI(-8.15,-3.00),P<0.0001]。结论唑来膦酸联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折能取得良好的疗效,可提高骨密度,减少骨折复发率,降低疼痛程度。Objective To systematically evaluate the efficacy and safety of zoledronic acid combined with percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures.Methods The randomized controlled trials(RCTs)of zoledronic acid combined with percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures were searched in China National Knowledge Infrastructure(CNKI),Cochrane Library and PubMed database from the establishment of the database to October 2021.The literature was screened according to the unified inclusion and exclusion criteria,and the original data were evaluated.The Cochrane bias risk assessment tool was used to evaluate the quality of RCT studies.Meta-analysis was performed using RevMan 5.4 software.Results A total of 9 studies involving 995 subjects were included.Meta-analysis showed that the bone mineral density of the treatment group was higher than that of the control group[MD=0.05,95%CI(0.03,0.07),P<0.0001];the incidence of postoperative fracture recurrence in the treatment group was lower than that in the control group[OR=0.13,95%CI(0.06,0.26),P<0.00001];the VAS score of the treatment group was lower than that of the control group[MD=-0.96,95%CI(-1.51,-0.40),P=0.0007];the ODI score of the treatment group was lower than that of the control group[MD=-5.58,95%CI(-8.15,-3.00),P<0.0001].Conclusion Zoledronic acid combined with percutaneous kyphoplasty can achieve good results in the treatment of osteoporotic vertebral compression fractures,which can improve bone mineral density,reduce fracture recurrence rate and reduce pain.

关 键 词：唑来膦酸 椎体后凸成形术 骨质疏松性椎体压缩性骨折 

分 类 号：R683.2[医药卫生—骨科学]