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肝硬化与骨折发生风险相关性的Meta分析
Liver cirrhosis and the risk of fracture: a Meta-analysis
文章发布日期:2017年05月04日  来源:  作者:赵健,李伟,梁才全,等  点击次数:290次  下载次数:44次

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【摘要】:目的从循证医学角度探讨肝硬化与骨折发生风险的相关性。方法通过计算机全面检索PubMed、Web of Science、Embase、CNKI、万方、中国生物医学文献、 维普等数据库已发表的肝硬化与骨折发生风险相关的观察性研究,对文献质量进行评价,采用RevMan5.3软件对骨折风险进行Meta分析,计算比值比(OR)和95%可信区间(95%CI)。结果最终纳入3个队列研究,2个横断面研究,肝硬化组28 820例,对照组214 313例。肝硬化组与对照组比较,总体骨折发生风险增加(合并研究:OR=2.07,95%CI:1.52~2.83,P<0.000 01;队列研究:OR=2.00,95%CI:1.93~2.07,P<0.000 01);按骨折类型进行分组分析,相比对照组,肝硬化组椎体骨折和非椎体骨折(上肢)发生风险均增加,(OR=2.10,95%CI:130~3.40,P=0.003;OR=1.61,95%CI:1.53~169,P<0.000 01)。结论肝硬化可增加骨折的发生风险,但由于所纳入的各研究间存在异质性,上述结论尚需更细致的研究来进一步证实。
【Abstract】:ObjectiveTo investigate the association between liver cirrhosis and the risk of fracture from the perspective of evidence-based medicine. MethodsPubMed, Web of Science, Embase, CNKI, Wanfang Data, SinoMed, and VIP were searched to collect published observational studies on the association between liver cirrhosis and fracture. The quality of each study was assessed and RevMan5.3 software was used to perform a meta-analysis of the risk of fracture, and the odds ratio (OR) and 95% confidence interval (CI) were calculated. ResultsThree cohort studies and two cross-sectional studies were included with 28 820 patients in liver cirrhosis group and 214 313 cases in control group. The analysis showed that compared with the control group, the liver cirrhosis group had a significant increase in the overall risk of fracture (all studies: OR=2.07, 95%CI: 1.52-2.83, P<0.000 01; cohort studies: OR=2.00, 95%CI: 1.93-2.07, P<0000 01). When the patients were divided according to the type of fracture, compared with the control group, the liver cirrhosis group had significant increases in the risks of vertebral fracture and non-vertebral fracture (upper extremities) (OR=2.10, 95%CI: 1.30-340, P=0.003; OR=1.61, 95%CI: 1.53-1.69, P<0.000 01). ConclusionLiver cirrhosis may increase the risk of fracture. However, due to the heterogeneity of these studies, the above results need to be further verified by more detailed studies.
【关键字】:肝硬化; 骨折; Meta分析
【Key words】:liver cirrhosis; fractures, bone; Meta-analysis
【引证本文】:赵健, 李伟, 梁才全, 等. 肝硬化与骨折发生风险相关性的Meta分析[J]. 临床肝胆病杂志, 2017, 33(6): 1112-1115.

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