成年人急性胰腺炎的药理干预:系统性审查的概述
Ling Ding1,2,3, Linge Jian4, Jiayue Xu1,2,3
1Chinese Evidence-Based Medicine Center and Cochrane China Center, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.
Journal of evidence-based medicine
|March 4, 2025
概括
药理干预表明急性胰腺炎 (AP) 治疗的潜力,一些药物对死亡率和器官衰竭有效. 然而,证据的确定性很低,需要进一步的研究来确认AP管理中的有效性和安全性.
科学领域:
- 胃肠道学和肝病学
- 临床药理学 临床药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 急性胰腺炎 (AP) 是一种严重的疾病,具有显著的发病率和死亡率.
- 药理干预措施经常被使用,但它们的有效性需要严格的评估.
- 需要对系统审查进行概述,以综合有关AP治疗的当前证据.
研究的目的:
- 综合评估急性胰腺炎 (AP) 药理干预措施的疗效和安全性.
- 评估特定药物对关键AP结果的影响,包括死亡率,器官衰竭和ICU停留.
- 根据证据确定性对发现进行分类,以指导未来的研究和临床实践.
主要方法:
- 随机对照试验 (RCT) 的系统审查,将成年AP患者的药理疗法与安慰剂进行比较.
- 在主要数据库 (PubMed,Embase,Cochrane) 进行的搜索截至2025年2月.
- 在5个结局中评估了14种药物的有效性,结果被分为有效,不有效或不确定的.
主要成果:
- 七种药物组合证明了对死亡率 (例如LMWH,omega-3抗氧化剂) 和器官衰竭 (例如LMWH,chengqi系列,urinastatin) 的低确定性证据的有效性.
- 尼奥斯蒂格明在减少ICU住院时间方面表现出有效性 (MD-2.81).
- 其余的一半组合没有有效性,另一半是不确定的,所有证据的确定性都很低;安全性数据有限.
结论:
- 某些药理干预措施对特定的急性胰腺炎结果有希望,但证据的确定性很低.
- 进一步高质量的研究是验证这些发现和改善AP治疗策略的必要条件.
- 目前的证据基础强调了对潜在的AP疗法的严格验证的必要性.
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