Do bisphosphonates affect bone healing? A meta-analysis of randomized controlled trials.
Do bisphosphonates affect bone healing? A meta-analysis of randomized controlled trials.
复制标题
双磷酸盐会影响骨愈合吗？
DOI：
10.1186/1749-799x-9-45
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发表时间：
2014-06-05
影响因子：
2.6
通讯作者：
Pan Z
中科院分区：
文献类型：
--
作者：
Xue D;Li F;Chen G;Yan S;Pan Z
背景双磷酸盐是否影响间接骨愈合尚不清楚。方法我们进行了全面的搜索策略。仅纳入随机对照试验。两名评审员独立评估方法学质量并提取结果数据。使用 RevMan 5.2 进行分析。结果纳入了 8 项符合条件的随机对照试验，涉及 2,508 名患者。荟萃分析结果显示，双膦酸盐输注组和对照组在短期（3个月内）（相对风险（RR）1.40，相对于对照组；95% CI 0.36至5.49）和术后长期（12个月以上）间接骨愈合（RR 1.0；95% CI 0.98至1.02）方面没有发现统计学显着差异。早期和延迟双磷酸盐给药组之间的间接骨愈合没有统计学上的显着差异。腰椎输注手术后输注双膦酸盐可以促进骨愈合并缩短术后 6 个月的融合时间（RR 1.35；95% CI 1.11 至 1.66）。 结论 双膦酸盐治疗后，没有临床上可检测到的因外部骨痂形成导致的骨折愈合延迟。考虑到双膦酸盐治疗骨质疏松症的益处，我们建议在骨折固定手术和腰椎融合手术后输注双膦酸盐。
BackgroundWhether bisphosphonates affect indirect bone healing is still unclear.MethodWe carried out a comprehensive search strategy. Only randomized controlled trials were included. Two reviewers independently assessed methodological qualities and extracted outcome data. Analysis was performed with RevMan 5.2.ResultsEight eligible randomized controlled trials with 2,508 patients were included. Meta-analysis results showed that no statistically significant differences were founded in indirect bone healing in short time (within 3 months) (relative risk (RR) 1.40, relative the control group; 95% CI 0.36 to 5.49) and in long-term (more than 12 months) postoperation (RR 1.0; 95% CI 0.98 to 1.02) between bisphosphonates infusion groups and control groups. There were no statistically significant differences of indirect bone healing between early and delay bisphosphonates administration groups. Bisphosphonates infusion after lumbar infusion surgery could promote bone healing and shorten fusion time in 6 months postoperation (RR 1.35; 95% CI 1.11 to 1.66).ConclusionThere was no clinically detectable delay to fracture healing via external callus formation following bisphosphonates treatment. Considering the benefit aspects of bisphosphonates for osteoporosis treatment, we recommend bisphosphonates infusion after fracture fixation surgery and lumbar fusion surgery.