粒细胞集落刺激因子对辅助生殖技术子宫内膜厚度及临床妊娠率的meta分析

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摘要目的系统评价宫腔内灌注粒细胞集落刺激因子(G-CSF)对体外受精-胚胎移植(IVF-ET)周期子宫内膜厚度及临床妊娠率的影响。方法计算机检索Medline、Cocharane Library、中国期刊全文及万方数据库,以及手工检索国内相关生殖杂志。检索G-CSF对IVF-ET周期中子宫内膜厚度或临床妊娠率的随机对照试验,由2名评价者按照纳入与排除标准选择试验,提取资料和评价质量,并采用RevMan5.3软件进行统计分析。结果最终纳入5个随机对照研究(RCT),共599例不孕患者,分干预组(宫腔内灌注G-CSF)和对照组(安慰剂或空白对照)。Meta分析结果显示,宫腔内灌注G-CSF可提高临床妊娠率[OR =1.87, 95% CI (1.32~2.66), P =0.0004],排除其他可能对子宫内膜及临床妊娠率有影响的因素,单纯性宫腔内灌注G-CSF和对照组比较,单纯性宫腔内灌注G-CSF可提高临床妊娠率[OR=2.29,95% CI(1.51~3.46),P<0.0001]。宫腔内G-CSF灌注前后比较,使用G-CSF后子宫内膜增加明显[MD=0.68,95% CI(0.27～1.08),Z=3.28, P=0.001];宫腔内灌注G-CSF与常规促子宫内膜增长方式相结合,宫腔内灌注G-CSF更有利于子宫内膜的增长[MD=0.87,95% CI(0.54~1.19),Z=5.25, P<0.00001]。结论宫腔内灌注G-CSF可促进IVF-ET周期子宫内膜生长并提高临床妊娠率。若能与常规促子宫内膜生长方式联合应用,其有效性可能更显著。

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	吴锦
	高天旸
	汤海瑜
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关键词 ：粒细胞集落刺激因子, 子宫内膜厚度, 临床妊娠率, 体外受精-胚胎移植

Abstract：Objective To evaluate the effect of intrauterine infusion of granulocyte colony-stimulating factor (G-CSF) on endometrial thickness and clinical pregnancy rate in the patients undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods We conducted a systemic search of Pubmed, Cochrane database, China National Knowledge Infrastructure (CNKI) and Wan-fang database, and manual retrieval of domestic related reproduction journals by using the following words: randomized controlled trails (RCT), G-CSF, IVF-ET, endometrial thickness, and clinical pregnancy rate. Meta-analysis was performed by using Revman 5.3 software. All the results were checked by two reviewers according to the inclusion and exclusion criteria selection test, study selection, data extraction, and quality assessment were performed in duplicate.Results A total of 599 infertile patients from 5 studies were included in the study. The patients were divided into two groups: the treatment groups (G-CSF) and the control groups (placebo or blank control), according to the use of intrauterine infusion G-CSF. The results showed that intrauterine infusion G-CSF can improve clinical pregnancy rate, OR=1.87, (95% CI: 1.32-2.66). To rule out other factors that may have an influence on the endometrium growth and clinical pregnancy rate, we only included intrauterine infusion of G-CSF group and compared it with the control group. The treatment was associated with increased odds of pregnancy (OR=2.29, 95% CI: 1.51-3.46); In addition, we made a comparison between before and after intrauterine infusion of G-CSF. We found that after infusion endometrial thickness was increased in the treatment group (MD=0.68, Z=3.28, 95% CI: 0.27-1.08); Intrauterine infusion G-CSF combined with conventional can promote endometrium growth, and perhaps more effective (MD=0.87, 95% CI (0.54-1.19), Z=5.25, P<0.00001).Conclusion G-CSF can promote the growth and improve the clinical pregnancy rate of IVF-ET. If it can be combined with the conventional method, it may be more effective.

Key words： Granulocyte colony stimulating factor Endometrial thickness Clinical pregnancy rate In vitro fertilization and embryo transfer

收稿日期: 2015-11-30

基金资助:广东省中医药管理局科研项目(2013207)

通讯作者: 高天旸(gaotiayang@yahoo.com)

引用本文:

吴锦, 高天旸, 汤海瑜, 任欣. 粒细胞集落刺激因子对辅助生殖技术子宫内膜厚度及临床妊娠率的meta分析[J]. 中国生育健康杂志, 2016, 27(4): 315-320.
WU Jin, GAO Tianyang, TANG Haiyu, REN Xin. Ganulocyte colony-stimulating factor and endometrial thickness and clinical pregnancy rate in assisted reproductive technology: a meta-analysis. Chinese Journal of Reproductive Health, 2016, 27(4): 315-320.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2016/V27/I4/315

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