CAJ | 학술논문

目的：系统评价高纯度人尿促卵泡素应用于超促排卵周期的临床疗效。方法计算机检索 PubMed、The Cochrane Library（2014年第7期）、Web of Science、EMBase、中国生物医学文献数据库、中国知网、维普和万方数据库，检索时限为从建库至2014年7月。收集试验组采用高纯度人尿促卵泡素进行超促排卵治疗，对照组采用基因重组促卵泡素进行超促排卵治疗的随机对照试验（RCT）或临床对照试验（CCT）。对纳入文献进行质量评价和数据提取，采用 RevMan 5.2软件对两组临床妊娠率、活产率、成熟卵数、获卵数、超促排卵刺激天数进行分析。结果共纳入10篇 RCT，4784例患者。两组临床妊娠率、活产率、成熟卵数、获卵数、超促排卵刺激天数比较，差异均无统计学意义〔OR ＝1.01，95％ CI（0.90，1.14），P ＝0.83；OR ＝1.04，95％ CI（0.91，1.19），P ＝0.56；MD ＝-0.21，95％ CI（-0.80，0.38），P ＝0.49；MD ＝-0.12，95％ CI（-0.82，0.58），P ＝0.73；MD ＝-0.40，95％ CI （-0.91，0.11），P ＝0.12〕。敏感性分析结果显示，两组获卵数和超促排卵刺激天数与原结果基本一致，具有较好的稳定性。漏斗图左右呈大致对称，存在发表偏倚的可能性较小。结论高纯度人尿促卵泡素在超促排卵周期中的临床疗效与基因重组促卵泡素相当。但由于受纳入文献数量和质量的限制，有待开展更多高质量、多中心研究加以验证。
목적：계통평개고순도인뇨촉란포소응용우초촉배란주기적림상료효。방법계산궤검색 PubMed、The Cochrane Library（2014년제7기）、Web of Science、EMBase、중국생물의학문헌수거고、중국지망、유보화만방수거고，검색시한위종건고지2014년7월。수집시험조채용고순도인뇨촉란포소진행초촉배란치료，대조조채용기인중조촉란포소진행초촉배란치료적수궤대조시험（RCT）혹림상대조시험（CCT）。대납입문헌진행질량평개화수거제취，채용 RevMan 5.2연건대량조림상임신솔、활산솔、성숙란수、획란수、초촉배란자격천수진행분석。결과공납입10편 RCT，4784례환자。량조림상임신솔、활산솔、성숙란수、획란수、초촉배란자격천수비교，차이균무통계학의의〔OR ＝1.01，95％ CI（0.90，1.14），P ＝0.83；OR ＝1.04，95％ CI（0.91，1.19），P ＝0.56；MD ＝-0.21，95％ CI（-0.80，0.38），P ＝0.49；MD ＝-0.12，95％ CI（-0.82，0.58），P ＝0.73；MD ＝-0.40，95％ CI （-0.91，0.11），P ＝0.12〕。민감성분석결과현시，량조획란수화초촉배란자격천수여원결과기본일치，구유교호적은정성。루두도좌우정대치대칭，존재발표편의적가능성교소。결론고순도인뇨촉란포소재초촉배란주기중적림상료효여기인중조촉란포소상당。단유우수납입문헌수량화질량적한제，유대개전경다고질량、다중심연구가이험증。
Objective To systematically review the clinical efficacy of high - purity follicle - stimulating hormone in the cycle of controlled ovarian hyperstimulation(COH). Methods We made computer retrieval from PubMed,The Cochrane Library(Issue 7,2014),Web of Science,EMBase,CBM,CNKI,VIP and Wanfang Data. The searching time range was set from database establishment to July 2014. Through the retrieval,we collected literatures about randomized controlled studies (RCT)or clinical controlled trical(CCT)which the trial group was administrated with COH by using high - purity follicle -stimulating hormone and the control group was administrated with COH by using genetically recombined follicle - stimulating hormone. Qualify evaluation and data extraction were conducted on the included literatures. RevMan 5. 2 software was used to analyze clinical pregnancy rate,live birth rate,the number of mature ovums,the number of retrieved oocytes and the number of COH days. Results We included 10 pieces of RCT literatures,concerning with 4 784 patients. The two groups were not significantly different in clinical pregnancy rate,live birth rate,the number of mature ovums,the number of retrieved oocytes and the number of COH days〔OR = 1. 01,95% CI(0. 90,1. 14),P = 0. 83;OR = 1. 04,95% CI(0. 91,1. 19),P =0. 56;MD = - 0. 21,95% CI( - 0. 80,0. 38),P = 0. 49;MD = - 0. 12,95% CI( - 0. 82,0. 58),P = 0. 73;MD =- 0. 40,95% CI( - 0. 91,0. 11),P = 0. 12〕. The sensitivity analysis showed that the number of retrieved oocytes and the number of COH days of the two groups were basically the same with original results,which indicated good stability. The funnel plot was generally symmetrical on two sides,indicating small possibility in publication bias. Conclusion Compared with genetically recombined follicle - stimulating hormone,high - purity follicle - stimulating hormone has same efficacy in the cycle of COH. However,due to the limited number and quality of included literatures,more high - quality and multi - center researches need to be carried out to verify the results of the study.