丸激素替代疗法对下尿路症状的影响:系统性审查和网络元分析
Xiang Yuan1, Xingyu Xiong2, Jianxin Xue1
1Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Journal of evidence-based medicine
|July 15, 2024
概括
替代疗法 (TRT) 不会在老年男性中恶化下尿道症状 (LUTS) 晚期发生的阴道腺症 (LOH). 肌内TRT可能是管理LOH和LUTS的首选途径.
科学领域:
- 安德罗学与人类学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 内分泌学 在内分泌学.
背景情况:
- 晚期发生的阴性腺体缺陷症 (LOH) 的老年男性通常会出现下泌尿道症状 (LUTS).
- 替代疗法 (TRT) 用于管理LOH,但其对LUT和前列腺参数的影响需要通过不同的施用途径进行澄清.
研究的目的:
- 进行一个网络元分析 (NMA),比较各种TRT给药途径 (通过皮肤,肌内,口服) 对LOH老年男性LUTS的疗效.
- 评估TRT路线对国际前列腺症状评分 (IPSS),前列腺特异性抗原 (PSA) 水平和前列腺体积的影响.
主要方法:
- 在多个数据库 (PubMed,Embase,Cochrane Library等) 中进行系统的文献搜索. 对于相关的随机对照试验 (RCT).
- 进行了基于TRT持续时间的网络元分析 (NMA) 和子组分析.
- 包括21个RCT与2453名参与者,分析IPSS,PSA水平和前列腺体积.
主要成果:
- 在对对的元分析中,通过皮肤,肌内和口服TRT途径之间没有观察到IPSS,PSA水平或前列腺体积的显著差异.
- 亚组分析显示,长期肌内TRT显著降低了IPSS (p=0.03).
- 短期的肌内TRT增加了前列腺体积 (p=0.04),短期的透皮TRT增加了PSA水平 (p<0.001). 积累性排名曲线下的表面 (SUCRA) 分析表明,肌内TRT有83%的概率是降低IPSS的最佳方法.
结论:
- 在老年男性中,TRT的施用途径不会加剧LOH的LUTS.
- 肌肉内TRT可能是管理LOH男性的LUTS的首选方法.
- 需要进一步的研究来证实这些发现并优化TRT策略.
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