类似葡萄糖-1受体激动剂对上胃肠内镜的影响:元分析
Antonio Facciorusso1, Daryl Ramai2, Jahnvi Dhar3
1Section of Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy; Clinical Effectiveness Research Group, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
概括
类似葡萄糖-1受体激动剂 (GLP-1RAs) 在上部内镜检查期间增加保留的胃含量和中止的手术. 然而,不良事件和吸收率是相似的,这表明调整的禁食可能是适当的.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 内分泌学 在内分泌学.
背景情况:
- 有限证据表明,葡萄糖类-1受体激动剂 (GLP-1RAs) 对上部内镜手术的影响有限.
- GLP-1RA越来越多地用于2型糖尿病和肥胖症,使其对内镜手术的影响具有临床意义.
研究的目的:
- 进行元分析,评估GLP-1RAs对上部内镜检查结果的影响.
- 评估GLP-1RA使用与留存的胃含量,手术成功和安全之间的关联.
主要方法:
- 在2024年5月之前进行了系统的文献搜索.
- 使用随机效应模型进行元分析,从13项研究 (84,065名患者) 汇集数据.
- 主要结局:保持胃含量 (RGC);次要结局:流产/重复手术,不良事件和吸收率.
主要成果:
- 与非使用者相比,GLP-1RA使用者的胃含量保留率 (OR,5.56) 显著更高.
- 调整后的分析证实GLP-1RA使用者的RGC升高 (aOR,4.20).
- 在GLP-1RA使用者中观察到更高的流产率 (OR,5.13) 和重复 (OR,2.19) 程序,但在不良事件或吸收率上没有显著差异.
结论:
- GLP-1RA的使用与在上部内镜检查过程中增加留存的胃含量和取消手术有关.
- 在GLP-1RA使用者和非使用者之间,不良事件和吸收率似乎没有显著差异.
- 调整禁食时间,而不是定期扣留GLP-1RAs,对于接受上部内镜检查的患者来说可能是一个合理的方法.
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