自体血小板浓缩物用于上颌窦底提升的系统评价再评价

The autologous platelet concentrates for maxillary sinus floor elevation:an overview of systematic reviews

目的评价自体血小板浓缩物(autologousplateletconcentrates,APC)用于上颌窦底提升的系统评价/Meta分析(SR/MA)的方法学质量和证据质量。方法计算机检索PubMed、Embase、CochraneLibrary、Scopus、CNKI、SinoMed、WanFang数据库,检索APC用于上颌窦底提升的SR/MA,检索时限均为建库至2022年8月31日。由2名审查员独立筛选文献、提取资料后,采用AMSTAR2和GRADE系统分别对纳入研究的方法学质量和相关结局指标的证据质量进行评估。结果共纳入13篇SR/MA,其主要结论为APC用于上颌窦底提升的积极作用有限,对窦底组织愈合可能有促进作用。AMSTAR2评价结果显示有9个条目报告为完整,2个项目未报告,总体质量较高;GRADE对46个结局指标进行证据等级划分,其中9个为高级,25个为中级,11个为低级,1个为极低。结论当前多数证据显示APC用于上颌窦底提升的积极作用有限,但相关SR/MA的方法学质量和结局指标的可靠程度不一致,仍需开展高质量临床研究进一步验证。

Objective To evaluate the quality of methodology and evidence of the systematic reviews and meta-analyses(SR/MA)of autologous platelet concentrates(APC)for maxillary sinus floor elevation(MSFE).Methods PubMed,Embase,Cochrane Library,Scopus,CNKI,SinoMed,and WanFang databases were electronically searched to enroll SR/MA of APC for MSFE from inception to August 31,2022.Two reviewers independently screened literature,extracted data,and employed the AMSTAR 2 and the GRADE for evaluating the quality of methodology of the included studies and the certainty of the evidence for outcomes respectively.Results A total of 13 SR/MA were included and the major conclusions were that APC presents limited influence on MSFE and might promote the healing of sinus tissue.The 9 items of AMSTAR 2 were reported well,and two items were not reported in any of the included SRs,and the quality was relatively convinced.The evidence grading of GRADE revealed that,in the total of 46 outcomes,9 were graded as high-level,25 as medium-level,11 as low-level,and 1 as extremely low-level.Conclusion Most of the current evidence shows the advantages of APC in MSFE are not obvious,but the reliability of SR/Ma is inconsistent.High-quality clinical trials are still needed to verify the efficacy of APC for MSFE.