不同干预措施对骨质疏松症患者跌倒或骨折的影响  

The effect of different interventions on falls or fractures in patients with osteoporosis

作　　者：魏杉杉 王玉环[1] 陶晶[2] 刘柯汝 王若仙 何斌[2] WEI Shanshan;WANG Yuhuan;TAO Jing;LIU Keru;WANG Ruoxian;HE Bin(Shihezi University School of Medical,Shihezi 832002,Xinjiang;SectionⅡ,Department of Orthopedics,the People’s Hospital of Shihezi City,Shihezi 832000,Xinjiang,China)

机构地区：[1]石河子大学医学院,新疆石河子832002 [2]石河子市人民医院骨二科,新疆石河子832002

出　　处：《中国骨质疏松杂志》2025年第1期124-130,共7页Chinese Journal of Osteoporosis

基　　金：新疆生产建设兵团科技创新人才计划(2022CB010-04)。

摘　　要：目的使用网状Meta分析不同干预措施对防治骨质疏松症患者跌倒或骨折的有效性及优先性。方法检索中、英文数据库中2024年1月30日前发表的随机对照试验。对纳入文献进行筛选、偏倚风险评估和证据质量评价后,采用Stata14.0软件进行网状Meta分析。结果纳入16项随机对照试验,共15141例患者,包括9种干预措施。网状Meta分析结果显示,在预防骨质疏松症患者跌倒方面,与常规干预相比,运动(OR=0.33,95%CI:0.16~0.70,P<0.05)、运动加药物(OR=0.46,95%CI:0.24~0.87,P<0.05)是减少跌倒的有效干预措施;SUCRA排序结果提示,运动、环境、教育、社交、跌倒评估和辅助技术的组合可能是防止骨质疏松症患者跌倒的优先推荐干预措施(SUCRA=90.3%)。在预防骨质疏松症患者骨折方面,已有干预措施间比较结果差异无统计学意义(P>0.05);SUCRA排序结果提示运动可能是减少骨质疏松症患者骨折的优先推荐干预措施(SUCRA=73.2%)。结论运动、运动加药物干预对减少骨质疏松症患者的跌倒有效。在预防骨折的不同干预中,运动可能是优先推荐的干预措施。但目前结论证据质量不足,未来仍需开展大样本、高质量的RCT试验予以验证。Objective To analyze the effectiveness and priority of different interventions for the prevention and treatment of falls or fractures in patients with osteoporosis by using network meta-analysis.Methods The randomized controlled trials(RCTs)published before January 30,2024,in Chinese and English databases were searched.After screening,the risk of bias assessment,and quality of evidence evaluation of the literature,network meta-analysis was performed using a Stata 14.0 software.Results Sixteen randomized controlled trials with a total of 15141 patients and 9 interventions were included.Meta-analysis showed that in the prevention of falls in patients with osteoporosis,exercise(OR=0.33,95%CI:0.16-0.70,P<0.05),and exercise plus medication(OR=0.46,95%CI:0.24-0.87,P<0.05)were effective interventions in reducing falls compared with usual interventions.SUCRA ranking result suggested that combination of exercise,environment,education,socialization,fall assessment,and assistive technology might be the priority recommended interventions for the prevention of falls in patients with osteoporosis(SUCRA=90.3%).For the prevention of fractures in patients with osteoporosis,there was no statistically significant difference in the result of the comparison of existing interventions(P>0.05).The result of the SUCRA ranking suggested that exercise might be the preferred recommended intervention for the reduction of fractures in patients with osteoporosis(SUCRA=73.2%).Conclusion Exercise and exercise plus medication interventions are effective in reducing falls in patients with osteoporosis.Among various fracture prevention interventions,exercise may be a preferred recommendation.However,the quality of the evidence is not good enough for the current findings.

关 键 词：骨质疏松症 跌倒 骨折 META分析 

分 类 号：R683[医药卫生—骨科学] R589.5[医药卫生—外科学]