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各种药物预防卵巢过度刺激综合征有效性的比较：一项随机对照试验的网络荟萃分析。

Comparison of the Effectiveness of Various Medicines in the Prevention of Ovarian Hyperstimulation Syndrome: A Network Meta-Analysis of Randomized Controlled Trials.

机构信息

Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Endocrinol (Lausanne). 2022 Jan 26;13:808517. doi: 10.3389/fendo.2022.808517. eCollection 2022.

DOI:10.3389/fendo.2022.808517
PMID:35154015
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8825486/
Abstract

BACKGROUND

Previous studies have described the effects of different drugs in preventing ovarian hyperstimulation syndrome (OHSS). However, the efficacies of those drugs in preventing OHSS remain inconclusive.

METHODS

We searched the PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. A network meta-analysis of randomized controlled trials (RCTs) was performed up to August 2021. We investigated the following drugs in our study: aspirin, albumin, metformin, calcium, cabergoline, quinagolide, letrozole, hydroxyethyl starch (HES), and glucocorticoids. The primary outcome was the incidence rate of moderate-to-severe OHSS, with the results presented as risk ratios (RRs) with 95% confidence intervals (CIs).

RESULTS

The incidence of moderate-to-severe OHSS was significantly reduced by calcium administration (risk ratios [RR] 0.14, 95% confidence interval [CI]: 0.04, 0.46) (grade: high), HES (RR 0.25, 95% CI 0.07, 0.73) (grade: high), and cabergoline (RR 0.43, 95% CI 0.24, 0.71) (grade: moderate). The surface under the cumulative ranking curve (SUCRA) indicated that calcium (SUCRA, 92.4%) was the most effective intervention for preventing moderate-to-severe OHSS. These drugs were safe and did not affect clinical pregnancy, miscarriage, or live birth rates.

CONCLUSION

Calcium, HES, and cabergoline could effectively and safely prevent moderate-to-severe OHSS, with calcium as the most effective intervention.

摘要

背景

先前的研究已经描述了不同药物预防卵巢过度刺激综合征（OHSS）的作用。然而，这些药物预防 OHSS 的疗效仍不确定。

方法

我们检索了 PubMed、Web of Science、Embase 和 Cochrane 对照试验中心注册库（CENTRAL）数据库。对截至 2021 年 8 月的随机对照试验（RCT）进行了网络荟萃分析。我们研究了以下药物：阿司匹林、白蛋白、二甲双胍、钙、卡麦角林、喹高利特、来曲唑、羟乙基淀粉（HES）和糖皮质激素。主要结局是中重度 OHSS 的发生率，结果以风险比（RR）和 95%置信区间（CI）表示。

结果

钙给药可显著降低中重度 OHSS 的发生率（RR 0.14，95%CI：0.04，0.46）（等级：高），HES（RR 0.25，95%CI：0.07，0.73）（等级：高）和卡麦角林（RR 0.43，95%CI：0.24，0.71）（等级：中）。累积排序曲线下面积（SUCRA）表明钙（SUCRA，92.4%）是预防中重度 OHSS 最有效的干预措施。这些药物安全，不影响临床妊娠、流产或活产率。

结论

钙、HES 和卡麦角林可有效且安全地预防中重度 OHSS，其中钙的效果最佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/bb8a7b0d6332/fendo-13-808517-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/18895d282f15/fendo-13-808517-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/6517f6306d1b/fendo-13-808517-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/1b97d741eda3/fendo-13-808517-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/bb8a7b0d6332/fendo-13-808517-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/18895d282f15/fendo-13-808517-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/6517f6306d1b/fendo-13-808517-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/1b97d741eda3/fendo-13-808517-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2abe/8825486/bb8a7b0d6332/fendo-13-808517-g004.jpg

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