生长抑素类似物联合培维索孟对肢端肥大症患者治疗效果及安全性的Meta分析  

Meta analysis of efficacy and safety of somatostatin analogues combined with Pevisomone in patients with acromegaly

作　　者：张丽[1] 刘翔[1] 刘萍[1] ZHANG Li;LIU Xiang;LIU Ping(Department of Endocrinology,General Hospital of Ningxia Medical University,Yinchuan,Ningxia 750004,China)

机构地区：[1]宁夏医科大学总医院内分泌科,宁夏银川750004

出　　处：《检验医学与临床》2023年第20期3020-3024,共5页Laboratory Medicine and Clinic

摘　　要：目的系统评价生长抑素类似物(SSA)联合培维索孟(PEG)在肢端肥大症患者中的治疗效果及安全性。方法在PubMed、Embase、Cochrane library、CNKI、CBM、维普、万方数据库中全面搜索相关文献,采用Rev Man 5.3软件进行Meta分析。结果共纳入11项研究,包括377例联合治疗组(SSA+PEG治疗)和176例单药治疗组(SSA治疗)肢端肥大症患者。Meta分析结果显示,联合治疗组胰岛素样生长因子-1(IGF-1)正常率更高,但与单药治疗组比较,差异无统计学意义(OR=1.15,95%CI:0.61~2.19,P=0.66)。单药治疗组转氨酶升高比例更小,安全性更好,但与联合治疗组比较,差异无统计学意义(OR=0.63,95%CI:0.35~1.16,P=0.14)。结论对于大剂量SSA治疗无效的肢端肥大症患者,联合使用PEG可作为备选治疗方案,可能提高IGF-1正常率,安全性良好。Objective To evaluate the efficacy and safety of somatostatin analogue(SSA)combined with pevisomine(PEG)in the treatment of acromegaly.Methods PubMed,Embase,Cochrane library,CNKI,CBM,VIP and Wanfang databases were searched for relevant articles.Rev Man 5.3 software was used for meta-analysis.Results A total of 11 studies were included,including 377 patients with acromegaly in combination treatment group(SSA+PEG treatment)and 176 patients in monotherapy group(SSA treatment).The results of Meta analysis showed that the normal rate of insulin-like growth factor-1(IGF-1)in combination treatment group was higher than that in monotherapy group,but the difference was not statistically significant(OR=1.15,95%CI:0.61-2.19,P=0.66).Compared with combination therapy group,monotherapy group had a lower proportion of elevated transaminase and a better safety profile,but the difference was not statistically significant(OR=0.63,95%CI:0.35-1.16,P=0.14).Conclusion For acromegaly patients who failed to respond to high-dose SSA treatment,the combination of PEG and SSA can be used as an alternative therapy,which may improve the normal rate of IGF-1 and has good safety.

关 键 词：肢端肥大症 生长抑素类似物 培维索孟 META分析 

分 类 号：R739.41[医药卫生—肿瘤]