促性腺释放激素类似物对中枢性性早熟儿童体格发育的影响：一项随机对照试验的Meta分析-现代医学

促性腺释放激素类似物对中枢性性早熟儿童体格发育的影响：一项随机对照试验的Meta分析

单位：海南西部中心医院儿内科, 海南儋州 571700

分类号：R729

出版年·卷·期（页码）：2024·52·第三期（446-452）

摘要：

目的：采用荟萃(Meta)分析方法探讨促性腺释放激素类似物(GnRHa)对中枢性性早熟(CPP)儿童体格发育的影响，为CPP儿童的治疗提供临床决策依据。方法：系统检索Pubmed、Web of Science、中国知网(CNKI)和万方(Wanfang)数据库自建库至2022年8月，获取相关研究的文献并进行筛选后合并分析。结果：共纳入12项研究，835例患者。在实际最终身高与预测最终身高的差值上，GnRHa治疗组显著高于对照组，差异有统计学意义[均数差(MD)=5.80, 95%CI: 3.68~7.91, P＜0.05]。GnRHa治疗组患者治疗期间的身高增长显著高于对照组，差异有统计学意义[标准化均数差(SMD)=0.34, 95%CI: 0.16~0.53, P＜ 0.05]；GnRHa治疗组的BMI增长显著低于对照组，差异有统计学意义(MD=-0.65, 95%CI:-1.14~-0.15, P＜0.05)。结论：GnRHa治疗CPP儿童能使患儿的实际身高更优于预测身高，且治疗期间身高增长高于未治疗患者，BMI增长低于未治疗患者，此结论需要更多的随机对照试验进一步证实。

Objective: To explore the effect of gonadotropin-releasing hormone analogues(GnRHa) on the physical development of children with central precocious puberty(CPP) using a Meta-analysis approach, in order to provide clinical decision-making support for the treatment of children with CPP. Methods: A systematic search was conducted in Pubmed, Web of Science, China National Knowledge Infrastructure(CNKI), and Wanfang databases up to August 2022 to retrieve related studies for inclusion and Meta-analysis.Results: A total of 12 studies involving 835 patients were included. The difference in actual final height versus predicted final height was significantly greater in the GnRHa treatment group compared to the control group, with a statistically significant difference(MD=5.80, 95%CI: 3.68-7.91, P＜0.05). The height growth during treatment in the GnRHa group was significantly higher than that in the control group, with a statistically significant difference(SMD=0.34, 95%CI: 0.16-0.53, P＜0.05); the BMI growth in the GnRHa treatment group was significantly lower than that in the control group, with a statistically significant difference(MD=-0.65, 95%CI:-1.14- -0.15, P<0.05).Conclusion: GnRHa treatment for children with CPP can lead to a greater actual height compared to predicted height, and the height growth during treatment is higher than that in untreated patients, while BMI growth is lower than in untreated patients. This conclusion requires further confirmation through more randomized controlled trials.

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