与药物相关的颌骨坏死复发相关因素：五年经验。
Recurrence-Related Factors of Medication-Related Osteonecrosis of the Jaw: A Five-Year Experience.
机构信息
Attending, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China.
Resident, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China.
出版信息
J Oral Maxillofac Surg. 2021 Dec;79(12):2472-2481. doi: 10.1016/j.joms.2021.07.029. Epub 2021 Aug 8.
PURPOSE
The treatment of medication-related osteonecrosis of the jaw (MRONJ) is greatly challenging for surgeons. In this study, we reviewed patients with MRONJ treated in our hospital in the past 5 years and explored the risk factors of recurrence.
METHODS
A retrospective cohort study was conducted to review the patients with MRONJ from January 1, 2016 to December 31, 2020. All patients received a monthly intravenous application of zoledronic acid. The primary outcome variable was the treatment outcome during follow-up. The predictor variables were local and systemic factors related to the treatment outcome. Multivariate logistic regression analysis was performed to identify the risk factors of recurrence after MRONJ treatment.
RESULTS
A total of 58 patients (62 sites) were included in this study. In multivariate regression analysis, the risk factor associated with recurrence after MRONJ treatment was the duration of medication of more than 18 months (odds ratio = 7.346; 95% confidence interval: 1.461-36.946; P = .016).
CONCLUSIONS
Using zoledronic acid over 18 months may increase the risk of recurrence in MRONJ patients.
目的
药物相关性颌骨坏死（MRONJ）的治疗对外科医生来说极具挑战性。在本研究中，我们回顾了过去 5 年在我院治疗的 MRONJ 患者，并探讨了其复发的危险因素。
方法
采用回顾性队列研究，对 2016 年 1 月 1 日至 2020 年 12 月 31 日期间我院收治的 MRONJ 患者进行研究。所有患者均接受每月一次静脉应用唑来膦酸治疗。主要观察变量为随访期间的治疗结果。预测变量为与治疗结果相关的局部和全身因素。采用多变量逻辑回归分析确定 MRONJ 治疗后复发的危险因素。
结果
本研究共纳入 58 例患者（62 个部位）。多变量回归分析显示，MRONJ 治疗后复发的危险因素是用药时间超过 18 个月（比值比=7.346；95%置信区间：1.461-36.946；P=0.016）。
结论
使用唑来膦酸超过 18 个月可能会增加 MRONJ 患者的复发风险。
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