由于儿科发病的炎症性肠病导致生长障碍的荷尔蒙疗法:系统性审查和分析与试验顺序分析
Mardhen Catunda Rocha Melo1, Rian Vilar Lima1, Maryana Modena Strada1
1Department of Medicine, University of Fortaleza, Fortaleza, Ceará, Brazil.
Journal of pediatric endocrinology & metabolism : JPEM
|April 8, 2025
概括
增长激素 (GH) 疗法在改善炎症性肠道疾病 (IBD) 的儿童的线性生长方面表现有前途. 这项研究表明,GH对于患有生长障碍的儿科IBD患者是有效和安全的.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 胃肠病学 胃肠病学
- 临床研究 临床研究
背景情况:
- 炎症性肠道疾病 (IBD) 在儿童中越来越多地被诊断出,通常会导致由于吸收不良而导致生长障碍.
- 针对儿科IBD患者生长缺陷的生长激素 (GH) 治疗的疗效和安全性仍在调查中,现有的研究产生了相互矛盾的结果.
研究的目的:
- 系统地评估生长激素 (GH) 治疗在被诊断患有炎症性肠病 (IBD) 和相关生长障碍的儿童中的有效性和安全性.
- 综合现有实验研究的证据,并进行试验顺序分析 (TSA),以确定研究结果的可靠性.
主要方法:
- 在遵循PRISMA指南的基础上,在MEDLINE,Embase和Cochrane图书馆数据库中进行了系统的文献搜索.
- 包括对接受GH治疗的IBD儿童的实验研究. 进行了TSA,以评估结果所需的样本大小.
- 分析了8项涉及127名患者 (78名接受GH治疗) 的研究数据,平均随访时间为1.3年.
主要成果:
- 在患有IBD的儿童中,GH疗法显著增加了身高标准偏差得分 (HtSDS) (SMD=1.07,p<0.0001),但与对照组相比并非如此 (SMD=0.18,p=0.70).
- 更长的随访时间与更大的HtSDS改善相关 (p=0.04). 高度速度 (HV) 在患者内部 (MD=4.09,p<0.0001) 和与对照组相比 (MD=4.47,p=0.0003) 显著增加.
- 没有观察到疾病活性 (PCDAI) 的显著变化. 副作用发生在15.51%的患者中,主要是注射部位. 交通安全局表示估计偏差风险低.
结论:
- 增长激素 (GH) 治疗在患有炎症性肠道疾病 (IBD) 的儿科患者中治疗生长障碍似乎是有效和安全的.
- 进一步进行高质量的随机对照试验 (RCT),采用标准化方法和延长后续,有必要巩固这些发现.
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