摘要
目的系统评价术前应用生长抑素类似物(somatostatin analog,SSA)对肢端肥大症治疗效果的影响。方法在Pubmed、Embase、Cochrane数据库检索1988年-2018年期间应用SSA治疗肢端肥大症的文献,采用RevMan 5.3软件进行Meta分析。结果共纳入13项研究,包含1472例肢端肥大症病人,行术前SSA治疗(术前SSA治疗组) 612例,仅行手术治疗(手术治疗组) 860例。对入选的所有研究行Meta分析显示:与手术治疗组比较,术前SSA治疗组并未显著提高肢端肥大症的缓解率(RR=0.86,95%CI:0.72-1.04,P=0.12);对入选的9项遵循统一缓解标准的研究进行Meta分析显示:与手术治疗组比较,术前SSA治疗组缓解率显著提高(RR=0.76,95%CI:0.60-0.97,P=0.03);对入选的5项前瞻性随机对照研究(randomized controlled trials,RCT)行Meta分析显示:与手术治疗组比较,术前SSA治疗组缓解率显著提高(RR=0.44,95%CI:0.30-0.64,P <0.0001)。结论术前应用SSA有可能提高肢端肥大症病人的缓解率。
Objective To systematically assess the effect of preoperative therapy with somatostatin analog(SSA) for acromegaly.Methods The literature about acromegaly with SSA treatment published from 1988 to 2018 were searched in Pub Med, Embase and Cochrane Library databases. A meta-analysis was performed by Rev Man 5.3 software. Results A total of 13 studies involving 1472 acromegaly patients were included. The preoperative therapy with SSA was performed in 612 patients(SSA group), and surgery alone was performed in 860 patients(surgery group). The results of meta-analysis for all of 13 studies included(RR=0.86, 95%CI: 0.72-1.04, P =0.12) and 9 studies following the same remission criteria for acromegaly(RR=0.76, 95%CI: 0.60-0.97, P = 0.03) showed, compared with the surgery group, the remission rate of acromegaly did not improve obviously in the SSA group. The results of meta-analysis for 5 randomized controlled trials(RCT) indicated that the remission rate in the SSA group was obviously higher than that in the surgery group(RR=0.44, 95%CI: 0.30-0.64, P < 0.0001). Conclusion Preoperative therapy with SSA may improve the remission rate of acromegaly.
作者
李振业
张鹏飞
桂松柏
赵澎
李储忠
曹磊
刘春晖
朱海波
张亚卓
Li Zhenye;Zhang Pengfei;Gui Songbai;Zhao Peng;Li Chuzhong;Cao Lei;Liu Chunhui;Zhu Haibo;Zhang Yazhuo(Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Beijing Neurosurgical Institute,Capital Medical University,Beijing 100070,China)
出处
《中国微侵袭神经外科杂志》
CAS
2020年第5期196-200,共5页
Chinese Journal of Minimally Invasive Neurosurgery
基金
国家自然科学基金青年科学基金项目(编号:81601205)。
