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Hyperprolactinemia (HPL) is a common side effect of antipsychotic medications. Recent reports suggest that aripiprazole can ameliorate antipsychotic-induced HPL, but results are inconsistent and the single available systematic review only considered five studies.Conduct an updated meta-analysis of all randomized controlled trials (RCTs) about the efficacy and safety of aripiprazole as an adjunctive treatment for antipsychotic-induced hyperprolactinemia.English and Chinese databases were searched for RCTs about the use of aripiprazole in treating antipsychotic-induced HPL published by January 20, 2015. Studies were selected using pre-defined inclusion and exclusion criteria. The Cochrane Risk of Bias tool was used to evaluate risk of biases, the Cochrane GRADE measure was used to assess the quality of evidence, and Review Manager 5.3 software was used for data analysis.A total of 21 studies, 19 of which were conducted in mainland China, were included in the analysis. Meta-analysis of data from 8 of the studies with a pooled sample of 604 individuals found that compared to the control condition adjunctive aripiprazole significantly increased the proportion of participants who experienced HPL recovery (risk ratio [RR]=19.2, 95%CI=11.0-33.5). The proportion who experienced any adverse effect during follow-up did not differ between the two groups, but the aripiprazole group was more likely to report somnolence (RR=2.76, 95%CI=1.34-5.69) and headaches (RR=2.31, 95%CI=1.08-4.92). High-dose aripiprazole (5mg/day) was more effective than low-dose (5mg/day) aripiprazole (RR=30.0, 95%CI=10.2-120.7 v. RR=15.1, 95%CI=8.1-28.1), but this difference was not statistically significant. The risk of bias in the studies was rated as 'high' in 6 of the studies and 'unclear' in 15 studies, and the quality of evidence was rated as 'high' for only 7 of the 57 outcome measures assessed.This study systematically reviewed and evaluated all relevant RCTs and found that adjunctive aripiprazole is effective and safe to use in the treatment of antipsychotic-induced HPL. However, the low quality of some of the studies, the incomplete methodological information provided for most of the studies, and the relatively short follow-up time of the studies raises question about the validity of the results. Further work that resolves these methodological and reporting issues is needed.高泌乳素血症是抗精神病药物治疗中一种常见的不良反应。近年来有报道提示阿立哌唑能减轻其他抗精神病药所致的高泌乳素血症，但不同研究的结果不尽一致。虽然已有一篇相关系统综述，但是只纳入了5项研究。.对有关阿立哌唑辅助治疗其他抗精神病药物所致高泌乳素血症的有效性和安全性的所有随机对照研究进行meta 分析。.检索国内外常用数据库中2015年1月20日前发表的所有关于阿立哌唑治疗其他抗精神病药物所致高泌乳血症的随机对照研究。按照预先规定的纳入标准及排除标准筛选相关研究。根据Cochrane偏移风险评估工具对纳入研究偏移风险进行评价，采用Cochrane GRADE评估证据质量，使用Review Manager 5.3和R3.1.1软件进行数据分析。.共纳入21 项随机对照研究，其中在中国大陆开展的研究有19 项。对21项研究中的8项研究共604例样本进行meta 分析，发现与对照组相比，阿立哌唑辅助治疗后，泌乳素水平恢复的患者比例显著增加（RR=19.2，95%CI =11.0-33.5）。两组患者在随访中出现不良反应的总的比例没有差异，但阿立哌唑组报告嗜睡（RR=2.76，95%CI=1.34-5.69）和 头痛（RR=2.31，95%CI=1.08-4.92）的比例相对高。高剂量阿立哌唑（5mg /d）比低剂量（5mg /d）更有效（RR=30.0，95%CI=10.2-120.7 比RR=15.1，95%CI=8.1-28.1），但这种差异无统计学意义。这些研究中有6 项被评为“ 高” 偏移风险，而其他15项的偏移风险“ 不清楚”。对57 个研究结果的证据水平评估显示只有7个是“ 高”质量的。.本研究系统地回顾和评估了所有相关的随机对照研究，发现阿立哌唑辅助治疗其他抗精神病药物所致的高泌乳素血症是安全有效的。然而，一些研究的质量较低，大多数研究的方法学信息不完善，研究中随访时间相对较短，这些都会影响研究结果的有效性。需要进一步工作以解决上述方法学和研究报告方面的问题。.本文全文中文版从2015年4月8日起在http://dx.doi.org/10.11919/j.issn.1002-0829.215014可供免费阅览下载. |
