GnRH类似物联合化疗对绝经前女性卵巢功能保护的Meta分析  

Adjuvant Gonadotropin-Releasing Hormone Analog for the Prevention of Chemotherapy to Preserve Ovarian Function in Premenopausal Women:A Meta-Analysis

作　　者：王倩 郎琳 贾英[1] 

机构地区：[1]重庆医科大学第一附属医院,400016

出　　处：《国际妇产科学杂志》2018年第1期94-100,共7页Journal of International Obstetrics and Gynecology

摘　　要：目的:探讨在化疗过程中促性腺激素释放激素(Gn RH)类似物对绝经前女性卵巢功能的保护。方法:计算机检索Pub Med、EMbase、Cochrane Library、中国知识资源总库(CNKI系列数据库)、中国生物医学文献数据库(CBM)、维普数据库、万方数据库,检索时间2000年1月—2017年7月。全面收集Gn RH类似物联合化疗对绝经前女性卵巢功能影响的临床试验,采用Cochrane系统评价的方法,提取数据,评价研究质量,并采用Rev Man 5.3软件进行合并分析。结果:共纳入13项随机对照试验(RCT)研究,包括1 539例患者。Gn RH类似物联合化疗可明显保护绝经前女性卵巢功能(OR=2.42,95%CI:1.48~3.95,P=0.000 4)。其中7篇文献报道了妊娠率,结果显示Gn RH类似物联合化疗可增加妊娠率(OR=1.69,95%CI:1.06~2.69,P=0.03)。结论:Gn RH类似物联合化疗能够保护绝经前女性卵巢功能,提高妊娠率。Objective:To estimate whether gonadotropin-releasing hormone(Gn RH) analog administration during chemotherapy can protect premenopausal women against the ovarian toxicity. Methods:We searched the electronic bibliographic databases, including the Cochrane Library, Pub Med, EMbase, CBM, CNKI, VIP database and Wanfang database to assemble relevant clinical trials. The search covered January 2000 to July 2017 and clinical studies related to Gn RH analog co-treatment with chemotherapy to ovarian function in premenopausal women. Data were extracted and evaluated using the methods recommended by Cochrane handbook. The Rev Man 5.3 software was used for Meta-analysis. Results:Thirteen RCTs involving 1 539 patients were included. Gn RH analog co-treatment significantly increase ovarian function resumption( OR =2.42, 95%CI: 1.48~3.95, P=0.000 4). Seven trials mentioned pregnancy rates. The occurrence of spontaneous pregnancy showed statistically significant difference between Gn RH analog co-treatment and the control groups( OR=1.69, 95%CI: 1.06~2.69, P=0.03). Conclusions:Evidence from RCTs suggests a potential benefit of Gn RH analog co-treatment with chemotherapy in premenopausal women, with higher rates of resumption of ovarian function and improvement in pregnancy.

关 键 词：肿瘤 卵巢功能早衰 抗肿瘤联合化疗方案 促性腺素释放激素类似物 

分 类 号：R737.3[医药卫生—肿瘤]