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乌司他丁预防经内镜逆行胰胆管造影术后胰腺炎的 Meta 分析

李路 韦宏成 冯淑芬

临床肝胆病杂志2017,Vol.33Issue(1):110-115,6.
临床肝胆病杂志2017,Vol.33Issue(1):110-115,6.DOI:10.3969/j.issn.1001-5256.2017.01.024

乌司他丁预防经内镜逆行胰胆管造影术后胰腺炎的 Meta 分析

Clinical effect of ulinastatin in preventing pancreatitis after endoscopic retrograde cholangiopancreatography:a Meta -analysis

李路 1韦宏成 1冯淑芬1

作者信息

  • 1. 暨南大学附属第一医院 消化科,广州 510630
  • 折叠

摘要

Abstract

Objective To investigate the clinical effect of ulinastatin in preventing pancreatitis after endoscopic retrograde cholangiopancre-atography (ERCP).Methods The Cochrane Library,PubMed,EMBASE,CNKI,VIP,and Wanfang Data were searched for randomized controlled trials (RCTs)on ulinastatin for the prevention of post -ERCP pancreatitis published from 1970 to June 2016.Two researchers se-lected RCTs,extracted data,and evaluated methodological quality independently,and RevMan 5.3 software was used for the meta -analy-sis.The chi -square test was used for the heterogeneity analysis of RCTs included,and the funnel plots were used to evaluate publication bi-as.Results A total of six RCTs with 923 patients were included in this analysis.Compared with the placebo,ulinastatin had significantly better effects in preventing post -ERCP pancreatitis (OR =0.26,95%CI:0.13 -0.53,P =0.000 2),hyperamylasemia (OR =0.47, 95%CI:0.33 -0.67,P <0.001),and abdominal pain (OR =0.56,95%CI:0.34 -0.91,P =0.020).Compared with gabexate,uli-nastatin had similar effects in preventing post -ERCP pancreatitis,hyperamylasemia,and abdominal pain (P =0.52,0.13,and 0.79);low -dose ulinastatin also had similar effects as gabexate in preventing post -ERCP pancreatitis and hyperamylasemia (P =0.49 and 0.25).The funnel plots based on the effect of ulinastatin in preventing post -ERCP pancreatitis were slightly asymmetric,which suggested the presence of publication bias.Conclusion Ulinastatin (≥15 ×104 U)can effectively prevent post -ERCP pancreatitis,hyperlipi-demia,and abdominal pain in the general population and it is recommended to start using this drug before surgery.

关键词

胰腺炎/胰胆管造影术,内窥镜逆行/手术后并发症/乌司他丁/Meta 分析

Key words

pancreatitis/cholangiopancreatography,endoscopic retrograde/postoperative complications/ulinastatin/Meta -analysis

分类

医药卫生

引用本文复制引用

李路,韦宏成,冯淑芬..乌司他丁预防经内镜逆行胰胆管造影术后胰腺炎的 Meta 分析[J].临床肝胆病杂志,2017,33(1):110-115,6.

临床肝胆病杂志

OA北大核心CSTPCD

1001-5256

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