奥曲肽治疗肢端肥大症疗效及安全性的Meta分析

Meta-analysis of the Effect of Octreotide in the Treatment of Acromegaly

目的:系统评价奥曲肽治疗肢端肥大症的疗效。方法:计算机检索Cochrane图书馆、Medline、Embase、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、万方数据库,根据Cochrane系统评价方法对纳入的随机对照实验(RCT)进行方法学评价,并应用Revman 5.0软件进行Meta分析。结果:共纳入5个RCT,共计218例患者。Jadad评分均>3分。Meta分析结果显示:实验组干预后的血清GH及IGF-1的浓度低于对照组[MD=-19.15,95%CI(-24.32,-13.98)]及[MD=-21.37,95%CI(-26.15,-16.58)],实验组肿瘤体积缩小率大于对照组[RR=24.25,95%CI(4.87,120.79)],实验组腹泻的发生率与对照组的差异无统计意义[PR=1.69,95%CI(0.78,3.64)]。结论:奥曲肽能安全有效的降低肢端肥大症患者血清GH和IGF-1的浓度,并有利于缩小肿瘤体积。由于纳入试验质量和病例数的限制,该结论需进一步的研究证实。

Objective：To evaluate the effects of octreotide in the treatment of acromegaly.Methods：The Cochrane Library,Mediline,Embase,CBM,Wanfang and CNKI databases were searched.The method and Revman 5.0 by the Cochrane Collaboration were used to perform a meta-analysis of randomized controlled trails（RCTs）.Results：5 RCTs were included and 218 patients were involved in the study.Jadad scores were more than 3 points.The results of the meta-analysis demonstrated that octreotide was superior to placebo in decreasing the concentration of GH and IGF-1（[MD = - 19.15, 95%CI（-24.32,-13.98）],[MD = -21.37,95%CI（-26.15,-16.58）]）,and octreotide was more effective to reduce the tumor volume[RR =24.25,95%CI（4.84,120.79）],but there was no statistically significant difference in the incidence of diarrhea in the experimental group and the placebo group[RR = 1.69,95%CI（0.78,3.64）].Conclusion： Octreotide could safely and effectively lower serum GH and IGF-1 concentration in patients with acromegaly and shrink the tumor volume.Due to limitation of the induded trials,this conclusion needs to be validated by further studies.