CAJ | 학술논문

目的系统评价阿仑膦酸钠对绝经后妇女骨密度的影响. 方法计算机检索Cochrane图书馆、Pubmed、Embase数据库及中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(CNKI)、维普、万方数据库,截止时间为2013年9月,检索语种为中文和英文.纳入以绝经后妇女为研究对象,比较阿仑膦酸钠与安慰剂疗效为目的随机对照试验,评价所纳入临床试验的研究质量,并用RevMan5.2软件进行数据分析,采用Stata11.0软件构建Meta回归模型,探讨主要疗效指标产生异质性的来源. 结果纳入12个随机对照试验的5 466例患者.主要和次要疗效指标的Meta分析结果显示,服用阿仑膦酸钠10mg/1年、10 mg/2～3年和5 mg/2～3年对绝经后妇女腰椎、全髋、转子、股骨颈骨密度的升高程度均大于安慰剂对照组,腰椎骨密度的变化最大(加权均数差为5.39,95％oCI:4.03～6.76;7.70,95％CI:6.96～8.43;5.99,95％CI:5.16～6.82),其次为转子和股骨颈,且骨密度随用药时间和用药剂量的增加呈正相关. 结论阿仑膦酸钠治疗能有效改善绝经后妇女的骨量,建议阿仑膦酸钠治疗疗程至少2～3年.
목적 계통평개아륜련산납대절경후부녀골밀도적영향. 방법 계산궤검색Cochrane도서관、Pubmed、Embase수거고급중국생물의학문헌수거고(CBM)、중문과기기간전문수거고(CNKI)、유보、만방수거고,절지시간위2013년9월,검색어충위중문화영문.납입이절경후부녀위연구대상,비교아륜련산납여안위제료효위목적수궤대조시험,평개소납입림상시험적연구질량,병용RevMan5.2연건진행수거분석,채용Stata11.0연건구건Meta회귀모형,탐토주요료효지표산생이질성적래원. 결과 납입12개수궤대조시험적5 466례환자.주요화차요료효지표적Meta분석결과현시,복용아륜련산납10mg/1년、10 mg/2～3년화5 mg/2～3년대절경후부녀요추、전관、전자、고골경골밀도적승고정도균대우안위제대조조,요추골밀도적변화최대(가권균수차위5.39,95％oCI:4.03～6.76;7.70,95％CI:6.96～8.43;5.99,95％CI:5.16～6.82),기차위전자화고골경,차골밀도수용약시간화용약제량적증가정정상관. 결론 아륜련산납치료능유효개선절경후부녀적골량,건의아륜련산납치료료정지소2～3년.
Objective To systematically assess the efficacy of alendronate in improving bone mineral density (BMD) in postmenopausal women.Methods The databases such as the Cochrane Library,PubMed,EMBASE,CBM,CNKI and VIP were electronically searched for all randomized controlled trials (RCTs),with deadline of September 2013,without language restrictions.Women with postmenopausal osteoporosis were included as the research objects,the RCTs on the efficacy comparison between alendronate (tablets) and placebo were collected,and the quality of clinical trials were evaluated.RevMan5.2 software was used for analysis.Meta regression models were established by using the Stata1 1.0 software to discuss the source of heterogeneity of primaryindex for assessment of curative effect.Results Twelve studies with 5 466 patients were included.Meta analysis on primary and secondary curative effect index showed that conpared with placebo,alendronate (10mg daily/1 year,10mg daily/2-3 years and 5mg daily/2-3 years) significantly increased BMD at the lumbar spine,total hip,trochanter and femoral neck,and the changes oflumbar BMD were in maximum (WMD=5.39,7.70 and 5.99,95％CI:4.03 6.76;6.96-8.43;5.16-6.82;respectively),followed by the trochanter and the femoral neck,and the BMD was increased with the medication time and dosage.Conclusions Alendronate could effectively increase BMD in postmenopausal women,and we recommend that the treatment course of alendronate should be 2 3 years at least.