雄激素替代治疗对前列腺增生症影响的Meta分析  

Meta-analysis to the effect of androgen replacement therapy on prostate growth

作　　者：严璞[1] 崔元善[1] 张勇[1] 

机构地区：[1]首都医科大学附属北京天坛医院泌尿外科,北京100050

出　　处：《中国男科学杂志》2013年第7期21-26,31,共7页Chinese Journal of Andrology

基　　金：基金项目资助：“215”工程.北京市高层次卫生专业技术人才培养计划-学科骨干（2009-3-15）资助;首都医学发展基金（2009-2069）资助

摘　　要：目的评估雄激素替代疗法（AndrogenreplacementtherapyART）与前列腺增生的关系。方法回顾所有发表的雄激素治疗性腺机能减退的随机对照研究（RandomizedcontrolledtrialsRCT），并就ART对前列腺增生的影响进行Meta分析。搜索数据库有：PUBMED，EMBASE，CochraneControlledTrialsRegister。结果使用ART大于12个月的9个RCT纳入分析，使用3种给药途径（注射，经皮给药和口服）。发表偏倚用漏斗图来评价。与安慰剂相比，使用ART12～36个月后，患者前列腺特异性抗原（ProstatespecificantigenPSA）（注射：P=0．42；经皮给药：P=0．51；口服：P=0．57）、前列腺体积（注射：P=0．35；经皮给药：P=0．59；口服：P=0．47）、国际前列腺症状评分（internationalprostatesymptomscoreIPSS）（注射：P=0．34；经皮给药：P=0．32；口服：P=0．97）和最大尿流率（MaximumurinaryflowrateQmax）（注射：P=-0．11；经皮给药：P=0．63）差异无统计学意义。结论ART不会增加前列腺增生的风险。Objective To assess the relationship between androgen replacement therapy （ART） and prostate growth. Methods A literature review was performed on all published randomized controlled trials （RCT） of androgen treatment on hypogonadism and the effects of ART on Prostate growth were investigated via meta-analysis. The search included three databases： PUBMED, EMBASE, and the Cochrane Controlled Trials Register. Results A total of 9 RCTs were used in the analysis and each ART should be given 12 months or more. ART were given by three different administration methods （Injection, Transdermal and Oral）. The presence of publication bias was evaluated using a funnel plot. Compared with that of placebo, after ART therapy about 12-36 months, no significant changes were found in the PSA level （Injection P=-0.42; Transdermal P=0.51; Oral P=0.57）; the prostate volume （Injection P=0.35; Transdermal P=0.59; Oral P=0.47）; the IPSS （Injection P=-0.34; Transdermal P=-0.32; Oral P=-0.97） and the maximum flow rate （Injection P=0.11; Transdermal P=0.63）. Conclusion ART can not increase the risk of prostate growth.

关 键 词：雄激素 前列腺增生 荟萃分析 随机对照研究 

分 类 号：R697.33[医药卫生—泌尿科学]