葡萄糖类-1受体激动剂在上部内镜检查中增加胃固体残留率,特别是在患有复杂糖尿病的患者中:一项病例对照研究
Kevin Garza1, Eli Aminpour2, Janaki Shah1
1Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri, USA.
The American journal of gastroenterology
|March 27, 2024
概括
类似葡萄糖-1受体激动剂 (GLP-1RAs) 在内镜检查期间增加胃残留物,特别是在2型糖尿病 (T2DM) 患者中. 然而,这一发现并没有导致更多的程序复杂性.
科学领域:
- 胃肠病学 胃肠病学
- 内分泌学 在内分泌学.
背景情况:
- 类似葡萄糖-1受体激动剂 (GLP-1RAs) 广泛用于减肥和2型糖尿病 (T2DM).
- 众所周知,GLP-1RA延迟了胃空气的排出,这可能会增加内镜手术期间胃残留的风险.
研究的目的:
- 为了比较服用GLP-1RAs与匹配对照组的患者上部内镜上胃残留的频率.
- 为了确定与胃残留相关的风险因素和后果,GLP-1RA用户接受内镜手术.
主要方法:
- 连续3年5年进行内镜手术的患者的回顾性病例控制研究.
- 倾向性得分匹配用于将GLP-1RA用户与对照组进行比较.
- 通过内镜报告和图像评估胃残留物存在;在手术前没有扣留GLP-1RAs.
主要成果:
- 与对照组 (4%) 相比,GLP-1RA使用者的胃残留率 (14%) 显著更高.
- 在T2DM患者,胰岛素依赖患者和T2DM并发症患者中观察到残留物增加.
- 长时间的禁食,透明液体和下午的手术与较低的残留率有关.
结论:
- 使用GLP-1RA与胃残留物增加有关,特别是在T2DM患者中,超过单独阿片类药物的效果.
- 虽然T2DM并发症等危险因素会增加残留物,但禁食和清洁液体有保护作用.
- 尽管残留物增加,但没有观察到程序并发症或渴望的增加.
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