双膦酸盐预防全髋关节置换术后假体周围骨质吸收效果的系统评价

被引：0

作者：

梁广

机构：

[1] 广西医科大学

关键词：

双膦酸盐; 全髋关节置换术; 骨质吸收; 系统评价;

D O I：

暂无

年度学位：

2012

学位类型：

硕士

导师：

摘要：

目的：评价全髋关节置换术后使用双膦酸盐预防假体周围骨质吸收的有效性和安全性。方法：计算机检索Pubmed、Embase、OVID、Cochrane图书馆和CBM，并人工检索相关文献的参考文献。全面搜集并纳入使用双膦酸盐预防全髋关节置换术后假体周围骨质吸收的随机对照试验，提取相关数据及研究质量，并使用RevMan5.1软件进行Meta分析。结果:最终纳入16个随机对照试验，共827人。使用双膦酸盐治疗的患者共424人，使用安慰剂或未治疗的患者共403人。Meta分析结果提示：在术后3月及12月，使用双膦酸盐治疗的患者假体周围骨密度明显高于对照组[依次为：(MD=0.04,95%CI (0.02,0.07), P=0.002);(MD=0.06,95%CI(0.03,0.09), P=0.0004)]。在术后6月，使用双膦酸盐治疗的患者假体周围骨密度高于对照组，差异接近统计学意义[MD=0.03,95%CI (-0.00,0.06),P=0.05]。在术后24-36月及48-72月，使用双膦酸盐治疗的患者假体周围骨密度仍高于对照组，但是没有达到统计学意义[依次为：(MD=0.04,95%CI(-0.03,0.11), P=0.23);(MD=0.07,95%CI (-0.00,0.14), P=0.06)]。在术后6月及12月，使用双膦酸盐治疗的患者血清骨碱性磷酸酶及尿I型胶原均显著低于对照组(P值均＜0.05）。结论:双膦酸盐能够有效减少全髋关节置换术后早期假体周围骨质吸收，提高假体周围骨量，是目前预防术后假体周围骨质丢失的重要选择。但是双膦酸盐的长期效果尚未明确，需要进一步的研究。

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页数：58

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