GnRHa联合GH治疗中枢性性早熟女童有效性和安全性的Meta分析  

Efficacy and safety of gonadotropin-releasing hormone agonist plus growth hormone for central preco⁃cious puberty in girls: a Meta-analysis

作　　者：陆颖 陈林伟 LU Ying;CHEN Linwei(Department of Pharmacy,Taizhou People’s Hospital,Jiangsu Taizhou 225300,China)

机构地区：[1]泰州市人民医院药学部,江苏泰州225300

出　　处：《中国医院药学杂志》2024年第16期1909-1914,共6页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金项目(编号:81903802);泰州市第五期“311工程”科研项目(编号:RCRY202126)。

摘　　要：目的:系统评价促性腺激素释放激素类似物(gonadotropin-releasing hormone agonist,GnRHa)联合生长激素(growth hormone,GH)用于治疗中枢性性早熟女童的有效性和安全性,旨在为临床用药提供循证治疗依据。方法:计算机检索PubMed、Cochrane Library、Web of Science、万方、中国生物医学文献、中国知网和维普等数据库,收集GnRHa联合GH(试验组)对比GnRHa(对照组)用于治疗中枢性性早熟女童的相关文献,检索时限均为2020年1月至2023年11月。对文献筛选和提取后,运用RevMan 5.3软件进行Meta分析。结果:共纳入11篇文献,其中包括6个随机对照试验和5个临床对照试验,合计1 098例患者。Meta分析结果显示,在有效性方面,试验组患者预测成人身高的变化显著高于对照组[MD=4.01,95%CI(2.77,5.26),P<0.01],试验组的血清胰岛素样生长因子-1、胰岛素样生长因子结合蛋白-3均高于对照组,差异有统计学意义(P<0.01);在安全性方面,试验组和对照组不良反应发生率比较差异无统计学意义[OR=1.10,95%CI(0.74,1.64),P=0.62]。敏感性分析显示上述结果稳定可靠。发表偏倚分析显示本研究存在发表偏倚的可能性较小。结论:基于现有证据,GnRHa联合GH治疗中枢性性早熟女童的疗效确切,安全性较好,值得临床上推广。OBJECTIVE To systematically evaluate the efficacy and safety of gonadotropin-releasing hormone agonist(GnRHa)plus growth hormone(GH)for central precocious puberty in girls to provide evidence-based references for clinical dos⁃ing.METHODS From January 2020 to November 2023,the databases of PubMed,Cochrane Library,Web of Science,Wan⁃fang,China Biomedical Literature Database,CNKI and VIP were electronically searched for retrieving the relevant studies of GnRHa plus GH(trial group)versus GnRHa(control group)for central precocious puberty in girls.After literature review and data extraction,RevMan 5.3 software was utilized for Meta-analysis.RESULTS Six randomized controlled trials and 5 clinical controlled trials involving 1098 patients were retrieved.Regarding effectiveness,predict adult height of trial group was signifi⁃cantly higher than that of control group[MD=4.01,95%CI(2.77,5.26),P<0.01].And insulin-like growth factor-1 and insulin-like growth factor binding protein-3 were higher in trial group than those in control group.The differences were statistically significant(P<0.01).Regarding security,no significant inter-group difference existed in the incidence of adverse reactions[OR=1.10,95%CI(0.74,1.64),P=0.62].Results of sensitivity analysis indicated that study results were both stable and reliable.And the possibility of publication bias was low in this study.CONCLUSION On the basis of existing evidence,GnRHa plus GH offers decent efficacy and safety.It is worthy of wider clinical promotions.

关 键 词：促性腺激素释放激素类似物 生长激素 中枢性性早熟 女童 

分 类 号：R977.1[医药卫生—药品]