生长激素治疗短肠综合征患者随机对照试验荟萃分析

目的系统评价生长激素治疗短肠综合征的疗效和安全性。方法采用计算机检索、手工检索方法收集生长激素治疗短肠综合征的随机对照试验文献，按Cochrane协作网系统评价方法进行评价。结果共4个试验，70例患者被纳入本研究。Meta分析结果显示，生长激素能显著增加短肠综合征患者体重[MD＝1．66，95％CI（0．69，2．63），P〈0．01]，去脂体重[MD=1．93，95％CI（0．97，2．90），P〈O．01]，促进残余肠道对能量[MD=4．42，95％CI（0．26，8．58），P〈0．05]，氮[MD=4．85，95％CI（0．20，9．49），P〈0．05]，脂肪[MD=5．02，95％CI（0．21，9．82），P〈0．05]的吸收。结论生长激素治疗短肠综合征短期疗效是安全、有效的，远期疗效还有待大样本、多中心的随机对照研究进一步验证。

Growth hormone for intestinal adaptation in patients with short bowel syndrome:Meta-analysis of clinical trial

Objective To assess the efficacy and safety of growth hormone(GH) for patients with short bowel syndrome(SBS).Methods Electronic searches were performed to identify all publications describing randomized controlled trials(RCTs) of the use of GH with or without glutamine for the treatment of patients with SBS.The outcomes of interest were body weight,lean body mass,intestinal absorption function.Results Four trials involving 70 patients were included in the review.Meta-analysis of these trials suggested that GH had positive effect in terms of increased weight [MD = 1.66,95%CI(0.69,2.63),P < 0.01],lean body mass [MD = 1.93,95%CI(0.97,2.90),P < 0.01],energy absorption [MD = 4.42,95%CI(0.26,8.58),P < 0.05],nitrogen absorption [MD = 4.85,95%CI(0.20,9.49),P < 0.05],fat absorption [MD = 5.02,95%CI(0.21,9.82),P < 0.05] for patients with SBS.Adverse effects occurred during active treatment in all trials.Only one trial performed 12 weeks follow-up study.Conclusions The results suggest a possible short-term benefit in terms of body weight,lean body mass and absorptive capacities,while the definite conclusion of long-term efficacy of GH could not be obtained as yet.Large-scale,long-term follow-up RCTs are needed to confirm the efficacy and safety of GH in the future.