Article record

胰高血糖素样肽-1受体激动剂是否影响颈椎融合结局？一项系统评价与荟萃分析。

Do glucagon-like peptide-1 receptor agonists influence cervical fusion outcomes? A systematic review and meta-analysis.

综述 Meta耳科IF 2.8Q1

文献信息

PMID	42740823
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Matheus Loiola Magalhães Alves 查看其他 6 位作者 Antônio Olímpio da Silva Moura Costa；Julia do Vale Moura Costa；Gustavo Azevedo Garrido；João Victor Pereira Gonzalez；Julia Sader Neves Ferreira；Bernardo de Andrada Pereira
作者单位	Department of Medicine, Zarns College, Avenida Luís Viana Filho, 3230, Imbuí, Salvador, Bahia 41720-200, Brazil. 查看其他 4 条单位信息 Orthopedics and Traumatology Service, São Rafael Hospital, Avenida São Rafael, 2152, São Marcos, Salvador, Bahia 41253-190, Brazil.；Department of Medicine, Bahiana School of Medicine and Public Health, Avenida Dom João VI, 275, Brotas, Salvador, Bahia 40290-000, Brazil.；Department of Medicine, Santo Amaro University, Rua Isabel Schmidt, 349, Santo Amaro, São Paulo, São Paulo 04743-030, Brazil.；Department of Neurosurgery, The William W. Backus Hospital, Ayer Neuroscience Institute, Hartford HealthCare, 326 Washington Street, Norwich, CT 06360, United States.
期刊	North American Spine Society journal
SCI 分区	Q1
IF	2.8
研究类型	综述 Meta · 临床
所属专科	耳科

中文摘要

背景： 胰高血糖素样肽-1受体激动剂（GLP-1RAs）越来越多地用于肥胖和2型糖尿病患者，但其在颈椎融合中的手术特异性效应仍不明确。
方法： 按照PRISMA 2020和MOOSE进行系统评价与荟萃分析，并在PROSPERO前瞻性注册，检索了截至2026年4月28日的PubMed、Embase和Web of Science。纳入评估接受颈椎融合术成人围手术期使用GLP-1RA的比较性研究。两名评价者独立筛选研究、提取数据并评估偏倚风险。在Review Manager Web（RevMan Web）中进行随机效应荟萃分析。采用GRADE方法对临床重要结局的证据确定性进行评估。
结果： 共纳入6项倾向评分匹配的回顾性队列研究，涉及17,310例患者。在主要分析中，GLP-1RA使用与假关节形成（比值比[OR] 0.98，95%置信区间[CI] 0.33-2.89；p = .96）、吞咽困难（OR 0.89，95% CI 0.38-2.05；p = .68）、再入院（OR 0.67，95% CI 0.39-1.17；p = .12）或器械失败（OR 0.83，95% CI 0.44-1.56；p = .41）的显著差异无关。次要结局在组间也无显著差异。
结论： 围手术期使用GLP-1RA与颈椎融合术后结局较差的一致模式无关。需要采用标准化暴露和结局定义的前瞻性、手术特异性研究。

英文摘要

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in patients with obesity and type 2 diabetes, but their procedure-specific effects in cervical fusion remain unclear.
METHODS: A systematic review and meta-analysis following PRISMA 2020 and MOOSE, prospectively registered in PROSPERO, searched PubMed, Embase, and Web of Science through April 28, 2026. Comparative studies evaluating perioperative GLP-1RA use in adults undergoing cervical fusion were included. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects meta-analyses were performed in Review Manager Web (RevMan Web). Certainty of evidence was assessed using the GRADE approach for clinically important outcomes.
RESULTS: Six propensity score-matched retrospective cohort studies involving 17,310 patients were included. In the primary analyses, GLP-1RA use was not associated with significant differences in pseudarthrosis (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.33-2.89; p = .96), dysphagia (OR 0.89, 95% CI 0.38-2.05; p = .68), hospital readmission (OR 0.67, 95% CI 0.39-1.17; p = .12), or device failure (OR 0.83, 95% CI 0.44-1.56; p = .41). Secondary outcomes were also not significantly different between groups.
CONCLUSIONS: Perioperative GLP-1RA use was not associated with a consistent pattern of worse postoperative outcomes after cervical fusion. Prospective, procedure-specific studies with standardized exposure and outcome definitions are needed.