摘要
目的:系统评价减重手术对肥胖型多囊卵巢综合征(PCOS)的疗效。方法:计算机检索PubMed、Embase、MEDLINE、The Cochrane Library、CNKI与万方数据库,检索时限均截至2018年9月,纳入有关减重手术对肥胖型PCOS治疗效果的研究。按照纳入与排除标准筛选文献、提取数据,并对纳入研究进行方法学质量评价,使用Rev Man 5.3软件进行Meta分析。结果:最终纳入9项自身前后对照试验、234例肥胖型PCOS患者。Meta分析结果显示,术后患者月经异常(RR=0.23; 95%CI:0.12～0.43; P <0.00001)、多毛(RR=0.47; 95%CI:0.28～0.79; P=0.004)发生率降低,血清总睾酮(MD=-25. 84; 95%CI:-30.07～-21.62; P<0.00001)、游离睾酮(MD=-4.05,95%CI:-6.82～-1.29,P=0.004)下降,体重指数下降(MD=-14.51; 95%CI:-17.88～-11.14; P<0.00001),2型糖尿病(RR=0.09; 95%CI:0.02～0.31; P=0.0002)、高血压(RR=0.20; 95%CI:0.04～0.89; P=0.03)患病率降低。结论:减重手术可有效降低肥胖型PCOS患者月经异常的发生率,改善高雄激素临床表现及高雄激素血症,降低患者体重指数及合并2型糖尿病、高血压的患病率。
Objective:To systematically review the efficacy of bariatric surgery for obese polycystic ovary syndrome(PCOS)patients.Methods:Databases such as PubMed,Embase,MEDLINE,the Cochrane Library,CNKI and Wanfang were searched from inception to Sep.2018,all studies on bariatric surgery for obese PCOS were included.According to inclusion and exclusion criteria,reviewers screened literature,extracted data,and evaluated the methodological quality of included studies.Meta-analysis was performed using RevMan 5.3 software.Results:A total of 9 before and after self-control studies involving 234 obese PCOS patients were included.The results of meta-analysis showed that:after bariatric surgery,the patients had significant reduction in menstrual dysfunction prevalence(RR=0.23;95%CI:0.12-0.43;P﹤0.00001),hirsutism prevalence(RR=0.47;95%CI:0.28-0.79;P=0.004),total testosterone(MD=-25.84,95%CI:-30.07--21.62,P﹤0.00001),free testosterone(MD=-4.05,95%CI:-6.82--1.29,P=0.004),BMI(MD=-14.51;95%CI:-17.88^-11.14,P﹤0.00001),type 2 diabetes mellitus prevalence(RR=0.09;95%CI:0.02-0.31;P=0.0002)and hypertension prevalence(RR=0.20;95%CI:0.04-0.89;P=0.03).Conclusions:Bariatric surgery for obese PCOS patients is effective in reducing menstrual dysfunction incidence,relieving hyperandrogenism,reducing BMI,type 2 diabetes mellitus incidence and hypertension incidence.
作者
李莹洁
韩艺
何冰
LI Ying-jie;HAN Yi;HE Bing(Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《腹腔镜外科杂志》
2019年第1期4-10,共7页
Journal of Laparoscopic Surgery
基金
国家自然基金项目(编号:81570765)
辽宁省科学技术基金(编号:2015020539)
