他汀类药物治疗成人骨质疏松的系统评价_《中国循证医学杂志》

作者：

 邓珏琳 , 杨茗 , 岳冀蓉

四川大学华西医院老年科（成都 610041）;

关键词：

他汀类药物骨质疏松随机对照试验系统评价

DOI：

10.7507/1672-2531.20080059

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价他汀类药物治疗成人骨质疏松的疗效和安全性。
方法　计算机检索Cochrane图书馆（2007年第4期）、Cochrane图书馆临床对照试验资料库（2007年第4期）、MEDLINE（1990～2007.11）、EMbase（1990～2007.11）、Current Controlled Trials、The National Research Register、中国生物医学文献数据库（1990 ～ 2007.11）、中文科技期刊全文数据库（1990～2007.11）、中文学术期刊全文数据库（1990～2007.11 ）。手工检索《中国骨伤》、《中国骨科杂志》以及相关的中英文会议论文集。纳入他汀类药物治疗成人骨质疏松的随机对照试验，并对纳入研究进行质量评价。
结果　纳入2篇随机对照研究，由于临床异质性无法进行Meta分析。2项研究结果基本一致，他汀类药物对增加腰椎、髋部的骨密度及改善骨代谢指标无明显作用，但辛伐他汀可以增加前臂的骨密度。
结论　目前证据不支持他汀类药物可以增加腰椎、髋部的骨密度，改善骨代谢指标，不推荐他汀类药物用于治疗成人骨质疏松症。需进一步开展大样本、多中心随机、双盲、安慰剂对照试验来确定他汀类药物治疗骨质疏松的疗效。

引用本文： 邓珏琳,杨茗,岳冀蓉. 他汀类药物治疗成人骨质疏松的系统评价. 中国循证医学杂志, 2008, 08(4): 284-287. doi: 10.7507/1672-2531.20080059 复制

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2.	姚朗, 苏勇, 蒋华良. 他汀类调血脂药物的潜在新作用-抗骨质疏松. 中国新药与临床杂志, 2002, 21(4): 249-251.
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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.
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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, 苏勇, 蒋华良. 他汀类调血脂药物的潜在新作用-抗骨质疏松. 中国新药与临床杂志, 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.

《中国循证医学杂志》

他汀类药物治疗成人骨质疏松的系统评价

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《中国循证医学杂志》

他汀类药物治疗成人骨质疏松的系统评价

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