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肝脏脑病变与质子抑制剂在后患者的使用:系统性审查和元分析
Manesh K Gangwani1, Zohaib Ahmed2, Rizwan Ishtiaq3
1Department of Medicine, University of Toledo Medical Center, Toledo, OH, USA - gangwani.manesh@gmail.com.
Minerva gastroenterology
|October 27, 2023
概括
质子抑制剂 (PPI) 的使用与经过跨状肝脏内移植系统 (TIPS) 程序后肝脏脑病变 (HE) 的风险较高有关. 对于接受TIPS的患者,必要时建议使用较低的PPI剂量.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 临床药理学 临床药理学
- 医学统计 医学统计
背景情况:
- 肝脏脑病变 (HE) 是一个常见的并发症后,跨内肝脏移植系统分流 (TIPS) 放置.
- 质子抑制剂 (PPI) 已经成为发展HE的潜在独立风险因素.
- 了解这种关联对于治疗肝病患者至关重要.
研究的目的:
- 系统地审查和元分析PPI使用与TIPS患者的HE发病率之间的关联.
- 量化TIPS后患者与或没有PPI治疗的HE风险.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Cochrane,Web of Science) 进行全面的文献搜索,截至2022年2月.
- 对四项涉及825名患者的研究进行了分析.
- 使用95%置信区间 (CI) 计算几率比率 (OR),以比较PPI用户和非用户之间的HE风险.
主要成果:
- 分析包括来自四项研究的825名患者.
- 使用PPI的患者在TIPS后出现HE的风险显著增加 (OR3.39,P<0.01).
- 对于PPI使用者来说,医院住院时间平均为139.5天,而非使用者为215.2天.
结论:
- 在 TIPS 患者中,PPI 治疗与肝脏脑病变的风险增加有关.
- 应该考虑在这个患者群体中使用最低有效剂量的PPI.
- 需要进一步的大规模研究来证实这些发现并指导临床实践.
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