二膦酸盐对炎症性肠病合并骨质疏松患者骨密度影响的Meta分析

Bisphosphonate in treatment of inflammary bowel diseases patient with osteoporosis:result of a Meta-analysis

目的系统评价二膦酸盐对炎症性肠病(IBD)合并骨质疏松(OP)患者骨密度(BMD)的影响。方法我们以IBD合并骨质疏松的随机对照研究为限定条件,系统检索了从1980年1月到2009年4月的Med-line、Embase、Cochrane图书馆、中国生物医学文献、中国期刊网全文数据库和万方数据库,无语言限制,并将结果应用RevMan5.0.20软件进行Meta分析。结果最终纳入5项研究,共378例病例,所有纳入研究的病例均口服维生素D及钙盐作为基础治疗,3项研究采用安慰剂对照,Meta分析结果显示,二膦酸盐与对照组在改善椎骨OR=10.43,95%CI[3.18,17.67](P=0.005)及股骨密度OR=2.97,95%CI[1.55,4.39](P=0.00001)方面具有差异,结果具有统计学意义。结论二膦酸盐制剂联合维生素D和钙盐显著提高IBD合并骨质疏松患者的BMD。

Objective To assess whether the bisphosphonate is effective in preserving bone mass compared to vitamin D and calcium only in inflammatory bowel disease patients with osteoporosis.Methods Using Medline,Embase,Cochrane library database,CBM,CNKI and the Wangfangdate,a search for clinical studies of inflammatory bowel disease patients with osteoporosis was carried out.Without language restriction,all randomized controlled trials published in 1980 to April 2009,that reported the change of bone mineral density(BMD)have been collected,and a Meta analysis was done using RevMan 5.0.20 software.Results Five trials of 378 patients were identified in this Meta analysis.All participants were given daily calcium and vitamin D supplementation as basic therapy,treatment group received bisphosphonate,three trials controlled with placebo group.The results of Meta analysis showed significant difference between bisphosphonate group and control group,both in spine study group vs control group: OR=10.43,95% CI(3.18,17.67)(P=0.005) and hip study group vs control group: OR=2.97,95% CI(1.55,4.39)(P=0.00001).Conclusions Treatment with bisphosphonate combined with daily calcium and vitamin D supplementation,significantly increased BMD in patients with IBD and low bone mass.