中部早熟青春期或早期青春期儿童的药物治疗:系统性审查和元分析
Chunsong Yang1,2,3,4, Zheng Liu1,2,3,4, Linan Zeng1,2,3,4
1Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
淋巴激素释放激素激素治疗改善了中部早发性青春期 (CPP) 的儿童的最终身高. 与重组人体生长激素 (rhGH) 结合进一步提高有效性,但要考虑多囊性卵巢综合征的潜在风险.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 生殖医学 生殖医学
- 药物治疗 药物治疗
背景情况:
- 中心早熟青春期 (CPP) 和早期青春期 (EP) 的干预措施使用性腺激素释放激素激动剂 (GnRHa) 或 GnRHa与复合人体生长激素 (rhGH) 仍在争论中.
- 在CPP/EP中治疗干预的最佳时间需要进一步澄清.
研究的目的:
- 根据干预时间系统地审查和比较CPP/EP治疗方案的疗效和安全性.
- 评估GnRHa单一治疗与 rhGH联合治疗对最终身高 (FH) 和其他结果的影响.
主要方法:
- 在7个数据库和2个注册表中进行了全面的文献搜索,截至2023年12月.
- 来自随机对照试验和非随机研究的数据使用元分析进行了合成,包括子组分析.
- 两个独立审查员选了研究,提取了数据,并评估了偏见风险.
主要成果:
- 药物治疗显著改善了CPP/EP的女孩的最终身高 (FH).
- 较早的干预 (8岁之前) 和超过2年的rhGH联合治疗显示出更大的FH改善.
- 虽然FH的BMI受到影响很小,但联合治疗可能会增加多囊性卵巢综合征的长期风险.
结论:
- 在患有CPP的儿童中,GnRHa疗法有效改善FH.
- 与rhGH的联合治疗似乎可以提高FH药物治疗的有效性.
- 多囊卵巢综合征的潜在风险增加需要在开始治疗之前仔细考虑.
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