重组人促甲状腺激素在良性甲状腺肿放射碘治疗中的有效性及安全性的系统评价被引量：3

Efficacy and Safety of Recombinant Human TSH in Radioiodine Therapy for Benign Thyroid Goiter: A Meta-analysis

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摘要目的系统评价重组人促甲状腺激素(recombinant human TSH,rhTSH)在良性甲状腺肿放射碘治疗中的有效性和安全性。方法计算机检索PubMed、EBSCO、The Cochrane Library(2015年第6期)和CNKI数据库,搜集rhTSH在良性甲状腺肿放射碘治疗的相关随机对照试验(RCT),检索年限均为从1990年1月至2015年3月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入6个RCT。Meta分析结果显示:放射治疗后1年,试验组甲状腺体积显著减小[MD=0.14,95%CI(0.05,0.23),P=0.002]。放射治疗前后,游离T4、T3以及甲状腺自身抗体阳性病患的百分比在两组间差异均无统计学意义。rhTSH未显著增加甲亢及颈部疼痛的发生率。结论 rhTSH在良性甲状腺肿的放射碘治疗中是有效和安全的。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。 Objective To systematically review the efficacy and safety of recombinant human TSH （rhTSH） in radioiodine therapy for benign thyroid goiter. Methods We electronicaUy searched MEDLINE, EBSCO, The Cochrane Library （Issue 6, 2015） and CNKI databases from January 1990 to March 2015, to identify randomized controlled trials （RCTs） about rhTSH in radioiodine therapy of benign thyroid goiter. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies, and then meta-analysis was performed by using RevMan 5.3 software. Results A total of 6 RCTs were included. The results of meta-analysis showed that： compared with the control group, the thyroid volume was significantly reduced at 1 year after radiation in the rhTSH group （MD=0.14, 95%CI 0.05 to 0.23, P=0.002）. There were no significant differences in FT4, FT3 and the percentage of patients who had thyroid antibody between two groups before and after radiation. In addition, rhTSH did not significantly increase the incidence of hyperthyroidism and neck pain. Conclusion rhTSH is effective and safe in radioiodine therapy of benign thyroid goiter. Due to the limitation of quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

作者朱奇涵孙捷豪沈飞霞

机构地区温州医科大学附属第一医院内分泌科温州医科大学附属第一医院麻醉科

出处《中国循证医学杂志》 CSCD 2015年第11期1301-1308,共8页 Chinese Journal of Evidence-based Medicine

关键词重组人促甲状腺激素良性甲状腺肿系统评价 META分析随机对照试验 Recombinant human TSH Benign thyroid goiter Systematic review Meta-analysis Randomizedcontrolled trial

分类号 R581.1 [医药卫生—内分泌]

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