【摘要】 目的 探究甲硫咪唑（Methimazole, MMI）联合甲状腺素（Thyroxine, THY）治疗儿童甲状腺功能亢进（简称甲亢）的有效性和安全性。方法 系统检索中外各大数据库，收集甲硫咪唑治疗儿童甲亢的随机对照试验，联合组给予MMI+THY,对照组为单用MMI,检索时限均为建库至2021年11月。由2名研究者独立筛选文献、提取资料并评估纳入研究的偏倚风险，采用RevMan 5.3软件进行Meta分析。结果 共纳入30项RCT,包括2920例患者。与对照组相比，联合组治愈率（RR:1.22,95%CI:1.14～1.30）、有效性（RR:1.09,95%CI:1.03～1.16）增高，甲状腺体积（MD:-3.87 cm³、95%CI:-4.24～-3.50）、FT3(MD:-1.03 pg·mL^-1,95%CI:-1.54～-0.53)、FT4(MD:-3.34 pg·mL^-1,95%CI:-6.27～0.40)下降，ADR发生率（RR:0.29,95%CI:0.23～0.38）降低。但两组TSH(MD:-0.19 mIU·L^-1,95%CI:-0.89～0.51)的差异无统计学意义。结论 当前证据显示，MMI+THY联合用药治疗可增加儿童甲亢临床效果，并降低不良反应发生率。受纳入研究数量和质量的限制，上述结论仍需更多高质量研究进一步证实。更多还原

【Abstract】 OBJECTIVE To explore the efficacy and safety of methimazole（MMI） combined with thyroxine（THY） in the treatment of hyperthyroidism in children.METHODS The randomized controlled trials of methi-mazole in the treatment of hyperthyroidism in children were collected by systematic retrieval of major Chinese and foreign databases.The combined group was given MMI+THY,and the control group was given MMI alone.The retrieval time was set up until November 2021.Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies.Meta-analysis was performed using RevMan 5.3 software.RESULTS A total of 30 RCTs with 2920 randomized patients were included.Compared with the control group, the cure rate（RR:1.22,95% CI:1.14-1.30） and effective rate（RR:1.09,95% CI:1.03-1.16） in the combined group were higher.Thyroid volume（MD:-3.87 cm³,95% CI:-4.24～-3.50）,FT3(MD:-1.03 pg·mL^-1,95% CI:-1.54～-0.53),FT4(MD:-3.34 pg·mL^-1,95% CI:-6.27～0.40),ADR incidence（RR:0.29,95% CI:0.23-0.38） in the combined group were decreased.However, there was no significant difference in TSH(MD:-0.19 mIU·L^-1,95% CI:-0.89～0.51)changes between the two groups.CONCLUSION MMI+THY is more advantageous in the treatment of hyperthyroidism in children.Due to the limitations of the number and quality of the included studies, the above conclusions need to be further confirmed by more high-quality studies.更多还原