粒细胞刺激因子治疗不明原因复发性流产的meta分析

A Meta analysis of granulocyte stimulating factor for treating patients with unexplained recurrent abortion

目的:综合评价粒细胞刺激因子对不明原因复发性流产的疗效。方法:计算机检索Pubmed、Embase、Ovid、Medline、Cochrane、万方、中国知网、中国生物医学、维普等文献数据库,并辅以手工检索。检索时间截至2019年4月,按Cochrane系统评价方法由2名研究者收集并提取与粒细胞刺激因子治疗不明原因复发性流产相关的随机对照试验(RCT)数据,进行meta分析。结果:共纳入5篇RCT,患者共计536例。结果表明排卵期使用粒细胞集落刺激因子治疗不明原因复发性流产可以一定程度降低其流产率(RR 0.4,95%CI 0.26~0.61),对提高活产率可能有一定的益处(RR 1.35,95%CI 1.11~1.65);而确认妊娠后用药对活产率(RR 0.91,95%CI 0.71~1.17)和流产率(RR 1.09,95%CI 0.71~1.68)无明显疗效;粒细胞集落刺激因子的使用对新生儿体重无明显影响(MD 7.18,95%CI 143.62~129.27);未增加妊娠并发症(RR 0.30,95%CI 0.05~1.93)、皮疹(RR 2.65,95%CI 0.53~13.09)等不良反应的发生风险,用药后可能使患者白细胞增多(RR19.86,95%CI 3.76~104.78)。结论:排卵期使用粒细胞集落刺激因子治疗不明原因复发性流产可以一定程度提高活产率,降低其流产率。

Objective:To analyze the efficacy of granulocyte stimulating factor for treating patients with unexplained recurrent abortion by Meta analysis.Methods:The database,such as Pubmed,Embase,Ovid,Medline,Cochrane,wanfang full text database,cnki,China biomedical literature database,vip medicine and other literature databases,were electronic researched until April 2019,and supplemented articles were manual searched from magazines.According to the Cochrane systematic evaluation method,the data of related granulocyte stimulating factor for treating patients with unexplained recurrent abortion from randomized controlled trials(RCTs)were collected and extracted by two researchers.Results:A total of 5 RCTs were included,which included 536 patients.Granulocyte colony stimulating factor used during ovulation for treating patients with unexplained recurrent abortion decreased the abortion rate(RR 0.4,95%CI0.26 0.61)and increased the live birth rate(RR 1.35,95%CI 1.11 1.65).However,granulocyte colony stimulating factor used didn’t significantly effect on the live birth rate(RR 0.91,95%CI 0.71 1.17)and abortion rate(RR 1.09,95%CI 0.71 1.68),also did not significantly change the neonatal weight(MD 7.18,95%CI 143.62 129.27),did not increased risk of pregnancy complications(RR 0.30,95%CI 0.05 1.93),and did not increased the rates of side effects of drug,such as skin rash(RR 2.65,95%CI 0.53 13.09),but leukocytosis of patients had increased after granulocyte colony stimulating factor treatment(RR19.86,95%CI 3.76 104.78).Conclusion:The use of granulocyte colony stimulating factor during ovulation can improve the rate of live birth and reduce the rate of abortion of patients with unexplained recurrent abortion.