他汀類藥物治療成人骨質疏松的系統評價_《中國循證醫學雜志》

作者：

 鄧玨琳 , 楊茗 , 岳冀蓉

四川大學華西醫院老年科（成都 610041）;

關鍵詞：

他汀類藥物骨質疏松隨機對照試驗系統評價

DOI：

10.7507/1672-2531.20080059

視頻：

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目的　系統評價他汀類藥物治療成人骨質疏松的療效和安全性。
方法　計算機檢索Cochrane圖書館（2007年第4期）、Cochrane圖書館臨床對照試驗資料庫（2007年第4期）、MEDLINE（1990～2007.11）、EMbase（1990～2007.11）、Current Controlled Trials、The National Research Register、中國生物醫學文獻數據庫（1990 ～ 2007.11）、中文科技期刊全文數據庫（1990～2007.11）、中文學術期刊全文數據庫（1990～2007.11 ）。手工檢索《中國骨傷》、《中國骨科雜志》以及相關的中英文會議論文集。納入他汀類藥物治療成人骨質疏松的隨機對照試驗，并對納入研究進行質量評價。
結果　納入2篇隨機對照研究，由于臨床異質性無法進行Meta分析。2項研究結果基本一致，他汀類藥物對增加腰椎、髖部的骨密度及改善骨代謝指標無明顯作用，但辛伐他汀可以增加前臂的骨密度。
結論　目前證據不支持他汀類藥物可以增加腰椎、髖部的骨密度，改善骨代謝指標，不推薦他汀類藥物用于治療成人骨質疏松癥。需進一步開展大樣本、多中心隨機、雙盲、安慰劑對照試驗來確定他汀類藥物治療骨質疏松的療效。

引用本文： 鄧玨琳,楊茗,岳冀蓉. 他汀類藥物治療成人骨質疏松的系統評價. 中國循證醫學雜志, 2008, 08(4): 284-287. doi: 10.7507/1672-2531.20080059 復制

1.	Hanley DA, Josse RG. Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada: Introduction. CMAJ, 1996, (155): 921-923.
2.	姚朗, 蘇勇, 蔣華良. 他汀類調血脂藥物的潛在新作用-抗骨質疏松. 中國新藥與臨床雜志, 2002, 21(4): 249-251.
3.	Hatzigeorgiou C, Jackson JL. Hydroxymethylglutaryl-coenzyme A reductase inhibitors and osteoporosis: a meta-analysis. Osteoporos Int, 2005, 16(8): 990-998.
4.	Uzzan B, Cohen R, Nicolas P, et al. Effects of statins on bone mineral density: a meta-analysis of clinical studies. Bone, 2007, 40(6): 1581-1587.
5.	Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323(7303): 42-46.
6.	Bone HG, Kiel DP, Lindsay RS, et al. Effects of atorvastatin on bone in postmenopausal women with dyslipidemia: a double-blind, placebo-controlled, dose-ranging trial. J Clin Endocrinol Metab, 2007, 92(12): 4671-4677.
7.	Rejnmark L, Buus NH, Vestergaard P, et al. Effects of simvastatin on bone turnover and BMD: a 1-year randomized controlled trial in postmenopausal osteopenic women. J Bone Miner Res, 2004, 19(5): 737-744.
8.	Mundy G, Greet R, Harris S, et al. Stimulation of bone formation in vitro and in rodents by statins. Science, 1999, 286(3): 1946-1949.
9.	Bjarnason NH, Riis BJ, Christiansen C. The effect of fluvastatin on parameters of bone remodeling. Osteoporos Int, 2001, 12(5): 380-384.
10.	Reid IR, Hague W, Emberson J, et al. Effect of pravastatin on frequency of fracture in the LIPID study: secondary analysis of a randomised controlled trial. Long-term Intervention with Pravastatin in Ischaemic Disease. Lancet, 2001, 357(9255): 509-512.
11.	Wishart J, Horowitz M, Need A, et al. Relationship between forearm and vertebral mineral density in postmenopausal women with primary hyperparathyroidism. Arch Intern Med, 1990, 150(6): 1329-1331.
12.	Steven R, Douglas C. Do statins prevent both cardiovascular disease and fracture? JAMA, 2000, 283(24): 3255-3257.

1. Hanley DA, Josse RG. Prevention and management of osteoporosis: consensus statements from the Scientific Advisory Board of the Osteoporosis Society of Canada: Introduction. CMAJ, 1996, (155): 921-923.
2. 姚朗, 蘇勇, 蔣華良. 他汀類調血脂藥物的潛在新作用-抗骨質疏松. 中國新藥與臨床雜志, 2002, 21(4): 249-251.
3. Hatzigeorgiou C, Jackson JL. Hydroxymethylglutaryl-coenzyme A reductase inhibitors and osteoporosis: a meta-analysis. Osteoporos Int, 2005, 16(8): 990-998.
4. Uzzan B, Cohen R, Nicolas P, et al. Effects of statins on bone mineral density: a meta-analysis of clinical studies. Bone, 2007, 40(6): 1581-1587.
5. Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001, 323(7303): 42-46.
6. Bone HG, Kiel DP, Lindsay RS, et al. Effects of atorvastatin on bone in postmenopausal women with dyslipidemia: a double-blind, placebo-controlled, dose-ranging trial. J Clin Endocrinol Metab, 2007, 92(12): 4671-4677.
7. Rejnmark L, Buus NH, Vestergaard P, et al. Effects of simvastatin on bone turnover and BMD: a 1-year randomized controlled trial in postmenopausal osteopenic women. J Bone Miner Res, 2004, 19(5): 737-744.
8. Mundy G, Greet R, Harris S, et al. Stimulation of bone formation in vitro and in rodents by statins. Science, 1999, 286(3): 1946-1949.
9. Bjarnason NH, Riis BJ, Christiansen C. The effect of fluvastatin on parameters of bone remodeling. Osteoporos Int, 2001, 12(5): 380-384.
10. Reid IR, Hague W, Emberson J, et al. Effect of pravastatin on frequency of fracture in the LIPID study: secondary analysis of a randomised controlled trial. Long-term Intervention with Pravastatin in Ischaemic Disease. Lancet, 2001, 357(9255): 509-512.
11. Wishart J, Horowitz M, Need A, et al. Relationship between forearm and vertebral mineral density in postmenopausal women with primary hyperparathyroidism. Arch Intern Med, 1990, 150(6): 1329-1331.
12. Steven R, Douglas C. Do statins prevent both cardiovascular disease and fracture? JAMA, 2000, 283(24): 3255-3257.

《中國循證醫學雜志》

他汀類藥物治療成人骨質疏松的系統評價

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《中國循證醫學雜志》

他汀類藥物治療成人骨質疏松的系統評價

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