生长抑素类似物治疗Graves眼病有效性的Meta分析_《中国循证医学杂志》

作者：

石少敏 ,  贺冶冰

华中科技大学同济医学院附属同济医院内分泌科（武汉 430030）;

关键词：

Graves眼病生长抑素类似物临床活动性评分突眼度 Meta分析

DOI：

10.7507/1672-2531.20130019

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价生长抑素类似物治疗Graves眼病（GO）的有效性。
方法　计算机检索PubMed、EMbase、The Cochrane Library、WanFang Data、CNKI、VIP和CBM中关于生长抑素类似物治疗Graves眼病的随机对照试验（RCT），检索时间截至2012年3月，并追溯纳入文献的参考文献。由2位研究者按照纳入标准筛选文献、提取资料和评价纳入研究的方法学质量后，采用RevMan 5.0软件进行Meta分析。
结果　最终纳入5个RCT，共210例患者。Meta分析结果显示：生长抑素类似物治疗GO可降低临床活动性评分［MD=0.58，95%CI（0.02，1.13），P=0.04］，但尚不能证实可降低突眼度（mm）［MD=0.21，95%CI（–0.14，0.56），P=0.24］；对复视程度、球后体积、眼压、视力及眼球活动受限未显示出明显疗效；目前证据尚不能说明生长抑素类似物治疗GO有效［OR=1.32，95%CI（0.45，3.9），P=0.61］。
结论　生长抑素类似物治疗GO可降低患者的临床活动性评分，但未能明显降低突眼度，目前证据尚不能证实生长抑素类似物治疗GO有效。受纳入研究的质量和数量限制，上述结论尚需开展更多高质量RCT加以验证。

引用本文： 石少敏,贺冶冰. 生长抑素类似物治疗Graves眼病有效性的Meta分析. 中国循证医学杂志, 2013, 13(1): 106-111. doi: 10.7507/1672-2531.20130019 复制

1.	Bartalena L, Baldeschi L, Dickinson A, et al. Consensus statement of the European Group on Graves’ orbitopathy (EUGOGO) on management of GO. European Journal of Endocrinology, 2008, 158: 273-285.
2.	Bartalena L, Marcocci C, Tanda ML, et al. An update on medical management of Graves’ ophthalmopathy. J Endocrinol Invest, 2005, 28: 469-478.
3.	Bartalena L, Marcocci C, Pinchera A. Editorial: Somatostatin analogs for Graves’ ophthalmopathy - Do they bounce off like a rubber bullet? J Clin Endocrinol Metab, 2004, 89(12): 5908-5909.
4.	Kung AW, Michon J, Tai KS, et al. The effect of somatostatin versus corticosteroid in the treatment of Graves’ ophthalmopathy. Thyroid, 1996, 6(5): 381-384.
5.	Krassas GE, Dumas A, Pontikides N, et al. Somatostatin receptor scintigraphy and octreotide treatment in patients with thyroid eye disease. Clin Endocrinol, 1995, 42: 571-580.
6.	Wemeau JL, Caron P, Beckers A, et al. Octreotide (long-acting release formulation) treatment in patients with Graves’ orbitopathy: clinical results of a four-month, randomized, placebo-controlled, double-blind study. J Clin Endocrinol Metab, 2005, 90(2): 841-848.
7.	Chang TC, Liao SL. Slow-release lanreotide in Graves’ ophthalmopathy: A double-blind randomized, placebo-controlled clinical trial. J Endocrinol Invest, 2006, 29: 413-422.
8.	Stan MN, Garrity JA, Bradley EA, et al. Randomized, double-blind, placebo-controlled trial of long-acting release octreotide for treatment of Graves’ ophthalmopathy. J Clin Endocrinol Metab, 2006, 91(12): 4817-4824.
9.	Dickinson AJ, Vaidya B, Miller M, et al. Double-blind, placebo-controlled trial of octreotide long-acting repeatable (LAR) in thyroid-associated ophthalmopathy. J Clin Endocrinol Metab, 2004, 89(12): 5910-5915.
10.	Julian PT, Sally G (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. Available from: http://www.cochrane-handbook.org.
11.	Krassas GE, Kaltsas T, Dumad A, et al. Lanreotide in the treatment of patients with thyroid eye disease. European journal of endocrinology, 1997, 136: 416-422.
12.	Cozma I, Zhang L, Uddin J, et al. Modulation of expression of somatostatin receptor subtypes in Graves’ ophthalmopathy orbits: relevance to novel analogs. Am J Physiol Endocrinol Metab, 2007, 293: E1630-E1635.
13.	孙斌, 张朝霞. 生长抑素类药物治疗甲状腺相关性眼病的研究进展. 国际眼科纵览, 2011, 35(5): 303-306.
14.	刘志民李顾沈. 生长抑素类似物对Graves眼病治疗作用的Meta分析. 第二军医大学学报, 2004, 25(4): 426-430.
15.	Krassas GE, Doumas A, Kaltsas T, et al. Somatostatin receptor scintigraphy before and after treatment with somatostatin analogues in patients with thyroid eye disease. Thyroid, 1999, 9(1): 47-52.
16.	Pichler R, Maschek W, Holzinger C. Therapy with somatostatin analogs in patient with orbitopathy and positive Octreoscan. Acta Med Austriaca, 2001, 28: 99-101.

1. Bartalena L, Baldeschi L, Dickinson A, et al. Consensus statement of the European Group on Graves’ orbitopathy (EUGOGO) on management of GO. European Journal of Endocrinology, 2008, 158: 273-285.
2. Bartalena L, Marcocci C, Tanda ML, et al. An update on medical management of Graves’ ophthalmopathy. J Endocrinol Invest, 2005, 28: 469-478.
3. Bartalena L, Marcocci C, Pinchera A. Editorial: Somatostatin analogs for Graves’ ophthalmopathy - Do they bounce off like a rubber bullet? J Clin Endocrinol Metab, 2004, 89(12): 5908-5909.
4. Kung AW, Michon J, Tai KS, et al. The effect of somatostatin versus corticosteroid in the treatment of Graves’ ophthalmopathy. Thyroid, 1996, 6(5): 381-384.
5. Krassas GE, Dumas A, Pontikides N, et al. Somatostatin receptor scintigraphy and octreotide treatment in patients with thyroid eye disease. Clin Endocrinol, 1995, 42: 571-580.
6. Wemeau JL, Caron P, Beckers A, et al. Octreotide (long-acting release formulation) treatment in patients with Graves’ orbitopathy: clinical results of a four-month, randomized, placebo-controlled, double-blind study. J Clin Endocrinol Metab, 2005, 90(2): 841-848.
7. Chang TC, Liao SL. Slow-release lanreotide in Graves’ ophthalmopathy: A double-blind randomized, placebo-controlled clinical trial. J Endocrinol Invest, 2006, 29: 413-422.
8. Stan MN, Garrity JA, Bradley EA, et al. Randomized, double-blind, placebo-controlled trial of long-acting release octreotide for treatment of Graves’ ophthalmopathy. J Clin Endocrinol Metab, 2006, 91(12): 4817-4824.
9. Dickinson AJ, Vaidya B, Miller M, et al. Double-blind, placebo-controlled trial of octreotide long-acting repeatable (LAR) in thyroid-associated ophthalmopathy. J Clin Endocrinol Metab, 2004, 89(12): 5910-5915.
10. Julian PT, Sally G (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. Available from: http://www.cochrane-handbook.org.
11. Krassas GE, Kaltsas T, Dumad A, et al. Lanreotide in the treatment of patients with thyroid eye disease. European journal of endocrinology, 1997, 136: 416-422.
12. Cozma I, Zhang L, Uddin J, et al. Modulation of expression of somatostatin receptor subtypes in Graves’ ophthalmopathy orbits: relevance to novel analogs. Am J Physiol Endocrinol Metab, 2007, 293: E1630-E1635.
13. 孙斌, 张朝霞. 生长抑素类药物治疗甲状腺相关性眼病的研究进展. 国际眼科纵览, 2011, 35(5): 303-306.
14. 刘志民李顾沈. 生长抑素类似物对Graves眼病治疗作用的Meta分析. 第二军医大学学报, 2004, 25(4): 426-430.
15. Krassas GE, Doumas A, Kaltsas T, et al. Somatostatin receptor scintigraphy before and after treatment with somatostatin analogues in patients with thyroid eye disease. Thyroid, 1999, 9(1): 47-52.
16. Pichler R, Maschek W, Holzinger C. Therapy with somatostatin analogs in patient with orbitopathy and positive Octreoscan. Acta Med Austriaca, 2001, 28: 99-101.

《中国循证医学杂志》

生长抑素类似物治疗Graves眼病有效性的Meta分析

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《中国循证医学杂志》

生长抑素类似物治疗Graves眼病有效性的Meta分析

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