重组人生长激素治疗特发性身材矮小症疗效的系统评价  

Recombinant Human Growth Hormone for Idiopathic Short Stature: A Systematic Review

作　　者：高岚[1] 徐婧 杨凡[3] 康德英[4] 

机构地区：[1]中医中医科学院广安门医院,北京100053 [2]四川省成都市新津县妇幼保健院,成都611430 [3]四川大学华西妇产儿童医院,成都610041 [4]四川大学华西医院中国循证医学中心,成都610041

出　　处：《中国循证医学杂志》2012年第12期1516-1521,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价重组人生长激素(rhGH)治疗特发性身材矮小症的长期效果。方法计算机检索PubMed、ScienceDirect、EBSCOHost、EMbase、e Cochrane Library、CBM、CNKI和VIP数据库,检索时限为1985～2010年,搜集rhGH治疗特发性身材矮小症的随机对照试验(RCT)。按照Cochrane系统评价方法,由2名评价员独立进行文献筛选、资料提取和纳入研究的方法学质量评估后,采用RevMan 5.0软件进行Meta分析。结果最终纳入11个RCT,共607例特发性身材矮小症儿童。Meta分析结果显示:治疗1年后,rhGH组身高标准差积分(SDS)明显高于空白/安慰剂对照组[MD=0.29 SDS,95%CI(0.03,0.54),P=0.03],rhGH组身高增长速度(GV)明显高于空白/安慰剂对照组[MD=2.68 cm/年,95%CI(1.70,3.65),P<0.000 01],rhGH组成年SDS明显高于空白/安慰剂对照组[MD=0.46 SDS,95%CI(0.29,0.63),P<0.000 01]。结论 rhGH可有效促进特发性身材矮小儿童的生长。但由于纳入研究质量不高,样本量较少,其效果尚需更多高质量RCT进一步验证。Objective To evaluate long-term effectiveness of recombinant human growth hormone （rhGH） for children with idiopathic short stature （ISS）. Methods 3he randomized controlled trials （RCTs） about rhGH in treating ISS published from 1985 to 2010 were searched in PubMed, ScienceDirect, EBSCOHost, EMbase, The Cochrane Library, CBM, CNKI and VIP. According to the Cochrane Handbook, two reviewers independently screened literature, extracted data, assessed methodological quality, and conducted meta-analysis using RevMan 5.0 software. Results A total of 11 RCTs involving 607 ISS children were included. The results of meta-analysis showed that, compared with the blank/placebo control group after 1-year treatment, the rhGH group resulted in a significant increase in height standard deviation score （SDS） （MD=0.29, 95%CI 0.03 to 0.54, P=0.03）, growth velocity （MD=2.68 cm/year, 95%CI 1.70 to 3.65, P〈0.000 01）, and adult SDS （MD=0.46, 95%CI 0.29 to 0.63, P〈0.000 01）. Conclusion rhGH can effectively promote the growth of ISS children. But due to the limitation of quality and small sample size of the included studies, its effectiveness still needs to be further proved by more high quality RCTs.

关 键 词：重组人生长激素 特发性身材矮小症 系统评价 META分析 随机对照试验 

分 类 号：R725.9[医药卫生—儿科]