中文摘要：

目的：评价硫唑嘌呤/巯嘌呤对男性炎性肠病患者生育的影响。方法检索PubMed、Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库和中文科技期刊数据库，筛选符合纳入标准的随机对照试验、队列研究、病例对照研究或横断面研究文献。纳入标准为试验组患者在配偶受孕前服用硫唑嘌呤/巯嘌呤，对照组患者未服用或配偶受孕后服用硫唑嘌呤/巯嘌呤；结局指标为胎儿流产发生率、先天畸形发生率和早产发生率。采用RevMan 5.1.0软件进行统计分析，计算相对危险度（RR）和95%置信区间（CI）。结果3项回顾性队列研究纳入Meta分析，试验组177例，对照组247例。患者服用的药物均为巯嘌呤。3项研究的质量评价均存在中度偏倚风险。其中2项研究中试验组分为受孕前3个月未停药和停药2个亚组，另1项研究中试验组纳入的均为受孕前3个月未停药患者。分析结果显示，受孕前3个月未停药组与对照组比较，胎儿流产发生率[10.81%（8/74）比7.98%（13/163），RR=1.25，95% CI 为0.56~2.81]、先天畸形发生率[2.41%（2/83）比2.55%（4/157），RR=0.95，95%CI为0.18~5.07]和早产发生率[8.11%（3/37）比4.11%（3/73），RR=1.97，95%CI为0.42~9.30]差异均无统计学意义（均P〉0.05）；受孕前3个月停药组流产发生率[12.28%（7/57）]和早产发生率[2.27%（1/44）]与对照组[分别为7.98%（13/163）、4.11%（3/73）]比较，差异无统计学意义[ RR=1.97，95% CI为0.23~17.21；RR=0.55，95%CI为0.06~5.15；均P〉0.05]，但胎儿先天畸形发生率[8.77%（5/57）]高于对照组[1.23%（2/163）]，差异有统计学意义[ RR=4.93，95%CI为1.34~18.11，P〈0.05）；受孕前3个月未停药组与受孕前3个月停药组流产发生率、胎儿先天畸形发生率和早产发生率差异均无统计学意义（均 P 〉0.05）。结论现在文献的Meta分析未显示男性炎性肠病患者服用巯嘌呤可增

英文摘要：

Objective To evaluate the effects of azathioprine or mercaptopurine on fetal outcome of ＆ nbsp;male patients with inflammatory bowel disease. Methods The databases of PubMed,the Cochrane Library,CNKI,VIP,and CBM were searched. Randomized controlled trial,cohort study,case-control study and cross-sectional study were included. Male patients exposed to azathioprine or mercaptopurine before or during conception of their spouses were enrolled into the exposure group,while male patients who did not expose to azathioprine or mercaptopurine were enrolled into the control group. The outcomes included incidences of spontaneous abortion,congenital abnormalities and preterm birth. The Meta-analysis was performed using RevMan 5. 1. 0 software,the relative risk（ RR）and 95% confidence intervals（ CI）were calculated. Results Three retrospective cohort studies were entered,including 177 patients in the exposed group and 247 patients in the control group. Mercaptopurine was used in the 3 cohort studies. The risk of bias of the 3 cohort studies was moderate. There were 2 subgroups in the 2 cohort studies. One subgroup included patients who continued mercaptopurine 3 months before conception. The other subgroup included patients who stopped mercaptopurine 3 months before conception. One cohort study included patients who continued mercaptopurine within 3 months of conception. There was no statistically significant difference between continued mercaptopurine use group 3 months before conception and the control group in the risk of spontaneous abortion（10. 81%（8/74）vs. 7. 98%（13/163）,RR =1. 25,95%CI：0. 56-2. 81,P〉0. 05）,congenital abnormalities（2. 41%（2/83）vs. 2. 55%（4/157）,RR=0. 95,95%CI：0. 18-5. 07,P〉0. 05）,and preterm delivery（8. 11%（3/37）vs. 4. 11%（3/73）,RR=1. 97,95%CI：0. 42-9. 30,P〉0. 05）. There was no statistically significant difference between the group which stopped mercaptopurine 3 months before conception and the control group in the risk of spontaneous abortion （1