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GLP-1受体激活剂对上部胃肠道内镜的影响:更新的系统综述和元分析
Ahmad Abdulraheem1,2, Bara Abujaber3,4, Lindsay Ayers5
1Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA. ahmad.m.abdulraheem@medstar.net.
Surgical endoscopy
|July 9, 2025
概括
类似葡萄糖-1受体激动剂 (GLP-1RA) 显著增加胃残留量 (GRC),导致更多的EGD手术中断. 同时进行结肠镜检查可降低GLP-1RA使用者的GRC风险,而药物之间没有显著差异.
科学领域:
- 胃肠道学和内分泌学
- 药理安全和程序结果.
背景情况:
- 葡萄糖类-1受体激动剂 (GLP-1RA) 是广泛用于糖尿病和肥胖症的药物.
- 新出现的担忧将GLP-1RA与胃残留物含量 (GRC) 的增加联系在一起,可能导致吸入性肺炎和流产的食道胃管透镜 (EGD) 程序.
研究的目的:
- 更新GLP-1 RA对EGD结果的影响的证据,特别是GRC和愿望事件.
- 评估GLP-1RA使用者同时进行结肠镜检查 (CLN) 对GRC的影响.
- 为了比较不同GLP-1RA药物的GRC风险.
主要方法:
- 对PubMed,Embase,Cochrane数据库和主要胃肠病学会议摘要的系统审查 (至2024年11月).
- 对20项回顾性研究 (207,708名患者) 的元分析,评估GRC,吸气肺炎和堕胎的EGD.
- 网络元分析以比较特定GLP-1RA中的GRC风险;调整后的OR被组合起来以控制混因素.
主要成果:
- GLP-1 RA使用显著增加了GRC (OR:5.57) 和堕胎EGD的比例 (OR:4.90).
- 经过调整后的分析证实GLP-1RA使用与GRC增加之间存在显著的关联 (aOR:3.18).
- 没有发现吸收事件的显著差异;并发的CLN显示出对GRC的保护作用 (OR:0.27);没有确定GRC风险的特异性差异.
结论:
- GLP-1 RA的使用与增加的GRC和更高的EGD流程中断率显著相关.
- 同时进行结肠镜检查可能会减轻GLP-1RA使用者的GRC风险.
- 需要进一步的前性研究来充分阐明GLP-1RA对EGD结果的影响.
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