国际妇产科学杂志

国际妇产科学杂志 ›› 2018, Vol. 45 ›› Issue (1): 94-100.

• 论著 • 上一篇    下一篇

GnRH类似物联合化疗对绝经前女性卵巢功能保护的Meta分析

王倩，郎琳，贾英   

  1. 400016  重庆医科大学第一附属医院
  • 收稿日期:2017-10-20 修回日期:2017-12-28 出版日期:2018-02-15 发布日期:2018-02-15
  • 通讯作者: 贾英，E-mail：jiaying284@tom.com E-mail:jiaying284@tom.com

Adjuvant Gonadotropin-Releasing Hormone Analog for the Prevention of Chemotherapy to Preserve Ovarian Function in Premenopausal Women：A Meta-Analysis

WANG Qian，LANG Lin，JIA Ying   

  1. First Affiliated Hospital of Chongqing Medical University，Chongqing 400016，China
  • Received:2017-10-20 Revised:2017-12-28 Published:2018-02-15 Online:2018-02-15
  • Contact: JIA Ying，E-mail：jiaying284@tom.com E-mail:jiaying284@tom.com

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摘要： 目的：探讨在化疗过程中促性腺激素释放激素（GnRH）类似物对绝经前女性卵巢功能的保护。方法：计算机检索PubMed、EMbase、Cochrane Library、中国知识资源总库（CNKI系列数据库）、中国生物医学文献数据库（CBM）、维普数据库、万方数据库，检索时间2000年1月—2017年7月。全面收集GnRH类似物联合化疗对绝经前女性卵巢功能影响的临床试验，采用Cochrane系统评价的方法，提取数据，评价研究质量，并采用RevMan 5.3软件进行合并分析。结果：共纳入13项随机对照试验（RCT）研究，包括1 539例患者。GnRH类似物联合化疗可明显保护绝经前女性卵巢功能（OR=2.42，95%CI：1.48～3.95，P=0.000 4）。其中7篇文献报道了妊娠率，结果显示GnRH类似物联合化疗可增加妊娠率（OR=1.69，95%CI：1.06～2.69，P=0.03）。结论：GnRH类似物联合化疗能够保护绝经前女性卵巢功能，提高妊娠率。

关键词: 肿瘤, 卵巢功能早衰, 抗肿瘤联合化疗方案, 促性腺素释放激素类似物

Abstract: Objective：To estimate whether gonadotropin-releasing hormone (GnRH) analog administration during chemotherapy can protect premenopausal women against the ovarian toxicity. Methods：We searched the electronic bibliographic databases, including the Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP database and Wanfang database to assemble relevant clinical trials. The search covered January 2000 to July 2017 and clinical studies related to GnRH analog co-treatment with chemotherapy to ovarian function in premenopausal women. Data were extracted and evaluated using the methods recommended by Cochrane handbook. The RevMan 5.3 software was used for Meta-analysis. Results：Thirteen RCTs involving 1 539 patients were included. GnRH analog co-treatment significantly increase ovarian function resumption (OR=2.42, 95%CI: 1.48~3.95, P=0.000 4). Seven trials mentioned pregnancy rates. The occurrence of spontaneous pregnancy showed statistically significant difference between GnRH analog co-treatment and the control groups (OR=1.69, 95%CI: 1.06～2.69, P=0.03). Conclusions：Evidence from RCTs suggests a potential benefit of GnRH analog co-treatment with chemotherapy in premenopausal women, with higher rates of resumption of ovarian function and improvement in pregnancy.

Key words: Neoplasms, Ovarian failure, premature, Antineoplastic combined chemotherapy protocols, Gonadotropin-releasing hormone analog