CAJ | 학술논문

目的：评价口服二磷酸盐治疗儿童成骨不全症（ OI）的临床疗效。方法根据Cochrane系统评价方法，计算机检索PubMed、Embase、CENTRAL、中国生物医学文献数据库等，收集所有关于口服二磷酸盐治疗儿童OI的随机对照试验（ RCTs）。按照Cochrane协作网的标准对纳入研究的文章进行质量评估，并提取有效数据进行Meta分析。结果纳入6篇文献，共396例患儿。6篇文献的研究结果显示，二磷酸盐治疗可以降低四肢骨折的发生率（P＝0．010），并且可以增加腰椎骨密度的Z分（P＝0．0001）和百分比（P＝0．010）。二磷酸盐还可以增加体质量的Z分（P＝0．0001）。在生活质量方面，二磷酸盐治疗后患儿的自我照顾能力得到提高（P＝0．0003）。但是二磷酸盐治疗后，患儿的身高无明显增长（P＝0．42），疼痛也未能得到缓解（P＝0．13）。2组在上消化道不良事件的发生率方面差异无统计学意义（P＝0．82）。结论二磷酸盐治疗可以有效降低四肢骨折的发生率并提高腰椎的骨密度，可以促进生长，部分改善生活质量，并且不会引起上消化道不良事件。
목적：평개구복이린산염치료인동성골불전증（ OI）적림상료효。방법근거Cochrane계통평개방법，계산궤검색PubMed、Embase、CENTRAL、중국생물의학문헌수거고등，수집소유관우구복이린산염치료인동OI적수궤대조시험（ RCTs）。안조Cochrane협작망적표준대납입연구적문장진행질량평고，병제취유효수거진행Meta분석。결과납입6편문헌，공396례환인。6편문헌적연구결과현시，이린산염치료가이강저사지골절적발생솔（P＝0．010），병차가이증가요추골밀도적Z분（P＝0．0001）화백분비（P＝0．010）。이린산염환가이증가체질량적Z분（P＝0．0001）。재생활질량방면，이린산염치료후환인적자아조고능력득도제고（P＝0．0003）。단시이린산염치료후，환인적신고무명현증장（P＝0．42），동통야미능득도완해（P＝0．13）。2조재상소화도불량사건적발생솔방면차이무통계학의의（P＝0．82）。결론이린산염치료가이유효강저사지골절적발생솔병제고요추적골밀도，가이촉진생장，부분개선생활질량，병차불회인기상소화도불량사건。
Objective It is to evaluate the clinical efficacy of oral bisphosphonates in the treatment of children with osteo -genesis imperfecta (OI).Methods According to the standards of the Cochrane Collaboration , all of randomized controlled tri-als ( RCTs ) in which oral bisphosphonates was compared with placebo treatment for children with OI were searched in PubMed, Embase, CENTAL, CBM et al.The quality of the trials selected was evaluated and effective data was pooled for Me -ta analysis.Results Six RCTs with a total of 396 patients were screened for the present study .Results of these trials’ results showed that bisphosphonates treatment was superior to placebo in a lower risk of new peripheral fractures (P=0.010) and the significant difference favouring bisphosphonates in the increasing of lumbar spine bone mineral density Z -score (P=0.0001) and percentage (P=0.010).For growth, bisphosphonates could increase weight Z -scores (P=0.0001).For the quality of life, bisphosphonates treatment was better than placebo in a higher score of the ability of self -care (P=0.0003) and the mob-ility (P=0.07) although the difference was not significant .However, we found no difference in change of the height (P=0.42) and the pain score (P=0.13).Finally, the incidence of upper gastrointestinal adverse events were similar between the treatment and placebo groups (P=0.82).Conclusion Compared with placebo, oral bisphosphonates treatment could effec-tively reduce the incidence of new peripheral fractures and increase the lumbar spine BMD .Meanwhile, bisphosphonate thera-py also increased the growth and partly improve the quality of life but was not associated with the incidence of upper gastroin -testinal adverse events .