甘与NSAID结合用于预防ERCP后胰腺炎:对前性随机对照试验的元分析
Xuan Zhang1, Jing-Ming Zhang1, Wan Wei2
1Fuzhou First General Hospital Affiliated with Fujian Medical University, China.
Medicine
|July 5, 2024
概括
甘三酸盐 (GTN) 显著降低了ERCP后胰腺炎 (PEP) 的发生率. 与非类固醇抗炎药物 (NSAIDs) 结合GTN,与单独GTN相比,进一步降低PEP率,尽管严重程度没有显著影响.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
背景情况:
- 急性胰腺炎是内镜逆行胆血管细胞造影 (ERCP) 后的常见并发症,约有9.7%的病例发生.
- 临床指南表明,甘三酸盐 (GTN) 可能降低ERCP后胰腺炎 (PEP) 的发生率.
- 目前的指南缺乏关于使用GTN和非类固醇抗炎药物 (NSAIDs) 预防PEP的最终建议.
研究的目的:
- 评估单独或与NSAID一起使用的甘三酸盐 (GTN) 对预防ERCP后胰腺炎 (PEP) 的预防作用.
- 对GTN在PEP预防中的有效性进行随机对照试验 (RCT) 的元分析.
主要方法:
- 在PubMed,Embase,Web of Science和科克兰图书馆的系统文献搜索.
- 纳入标准:已发表的,全长的,随机对照试验 (RCT) 研究GTN (单独或与NSAID一起) 以预防PEP.
- 搜索术语包括ERCP,PEP,GTN (甘三酸盐/酸甘) 和NSAID.
主要成果:
- 分析了10个涉及3240名患者的RCT.
- 给予GTN显著降低了PEP的总体发病率 (P < .001).
- 与单独GTN相比,GTN加NSAID的PEP发病率明显较低 (1.01%对2.36%).
- 无论单独使用GTN还是与NSAID结合使用,都没有显著降低PEP的严重程度.
结论:
- 甘三酸盐 (GTN) 在预防ERCP后胰腺炎 (PEP) 中具有显著的益处.
- 与GTN和NSAID结合治疗在PEP预防方面似乎比单独使用GTN更有效.
- 需要进一步进行高质量的多中心RCT,采用大样本规模和长期随访,以确认这些发现,特别是关于PEP严重程度.
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