加尼瑞克应用于辅助生殖的有效性和安全性的Meta分析

Meta-analysis of ganirelix for assisted reproductive technology

目的评价醋酸加尼瑞克注射液对辅助生殖患者的有效性及安全性。方法系统检索Medline数据库、The Cochrane library、Wanfang和CNKI图书馆国内外醋酸加尼瑞克治疗控制性卵巢刺激的随机对照研究,采用Cochrane质量评价标准进行定量化质量评估,采用Rev Man 5.3进行系统统计分析。结果共纳入13项随机对照研究。Meta分析研究结果发现,与GnRH-a长方案相比,一般患者接受加尼瑞克治疗后有效率降低,但差别无统计学意义,而不良反应发生率降低,且具有统计学意义;多囊卵巢症患者的有效率和不良反应发生率差异无统计学意义;而卵巢弱反应性患者有效性和不良反应发生率均降低,且有统计学意义。不同GnRH-a类药物Meta分析显示:与曲普瑞林和布舍瑞林方案相比,患者接受加尼瑞克治疗有效率降低,安全性良好,差别均有统计学意义;与亮丙瑞林和那法瑞林方案相比,有效率降低但无统计学意义,安全性更好,且有统计学意义。结论从药物安全性、有效性角度出发,一般患者和PCOS患者接受ART时可选用加尼瑞克用于COS。

Objective To study the effectiveness and safety of ganirelix for assisted reproductive technology(ART).Methods Databases of Medline, Embase and Cochrane library were searched for randomised, double-blind, placebo-controlled trials(RCTs) concerning glucosamine treatment of OA. Quality evaluation were assessed by Cochrane quality evaluation standards and Meta-analysis by using Rev Man 5.3 were performed.Results A total of 13 studies contributed to the meta-analysis. Meta-analysis showed that there was no significant difference in the effective rate of general patients treated with Garniric compared with GnRH-a long-term regimen, but the incidence of adverse reactions was significantly reduced. It was significantly reduced for both efficacy and the adverse event rate for poor responds patients with ganirelix. Compared with triptorelin and buserelin, the efficacy was significantly reduced for patient with ganirelix. While comparing with leuprolide and nafarelin, there was no significant difference on efficacy and the adverse event rate for patience with ganirelix.Conclusion From the safety and efficacy of drug, ganirelix maybe a choice for COS in general patients and PCOS patients receiving ART.