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[目的]系统评价利塞膦酸盐影响原发性绝经后骨质疏松性骨折发生率的有效性和安全性。[方法]按照Cochrane协作网制订的检索策略进行检索,计算机检索MEDLINE(1966～2010年12月)、EMBASE(1974～2010年12月)、Cochrane图书馆(2010年第12期)、中国生物医学文献数据库(CBM,1978～2010年12月)、中国期刊全文数据库(CNKI,1994～2010年12月)、中文科技期刊全文数据库(VIP,1989～2010年12月)及万方数据库(1979～2010年12月)。手工检索相关的中英文骨科杂志和会议论文。纳入利塞膦酸盐影响原发性绝经后骨质疏松性骨折发生率的所有随机对照试验,由2名评价员独立提取资料,并对其方法学质量进行评价。对符合纳入标准的研究用RevMan 5.0软件进行Meta分析。[结果]共纳入7个随机对照试验。10 359例患者。Meta分析结果显示:利塞膦酸盐可以降低原发性绝经后骨质疏松性椎体骨折发生率[RR=0.66,95%CI(0.57,0.77)P<0.000 01];利塞膦酸盐可以降低原发性绝经后骨质疏松性非椎体骨折发生率[RR=0.69,95%CI(0.52,0.90)P=0.007];利塞膦酸盐可以降低原发性绝经后骨质疏松性髋部骨折发生率[RR=0.66,95%CI(0.49,0.90)P=0.008]。[结论]利塞膦酸盐有利于降低原发性绝经后骨质疏松性骨折的发生率,但限于纳入研究在方法学方面的局限性,尚需开展大样本、高质量的RCT进一步论证其疗效和安全性。
[Objective] To systematically evaluate the effectiveness and safety of risedronate in the incidence of primary postmenopausal osteoporotic fracture. [Methods] According to the search strategy developed by the Cochrane Collaboration, we searched MEDLINE (1966 ~ December 2010), EMBASE (1974 ~ December 2010), Cochrane Library (December 2010), China Biomedicine (CBM, December 1978 to December 2010), Chinese Journal Full-text Database (CNKI, December 1994 to December 2010), Full-text Database of Chinese Science and Technology Periodicals (VIP, 1989 to December 2010) and Wanfang Database (1979 ~ December 2010). Manually search relevant Chinese and English orthopedic magazines and conference papers. All randomized controlled trials of risedronate, which affected the incidence of primary postmenopausal osteoporotic fractures, were independently extracted by two reviewers and their methodological quality was evaluated. Meta-analysis was performed on RevMan 5.0 software that met the inclusion criteria. [Results] A total of 7 randomized controlled trials were included. 10 359 patients. Meta-analysis showed that risedronate reduced the incidence of primary osteoporotic vertebral fractures [RR = 0.66, 95% CI (0.57, 0.77) P <0.000 01]; risedronate Can reduce the incidence of primary postmenopausal osteoporotic non-vertebral fractures [RR = 0.69,95% CI (0.52,0.90) P = 0.007]; risedronate can reduce the incidence of primary postmenopausal osteoporosis The incidence of hip fracture [RR = 0.66, 95% CI (0.49, 0.90) P = 0.008]. [Conclusion] Risedronate is beneficial to reduce the incidence of primary postmenopausal osteoporotic fractures. However, limited to the methodological limitations of the included studies, large samples and high quality RCT are still needed Efficacy and safety.