J Gastroenterology:熊去氧胆酸可以降低胆结石和减肥手术后胆囊切除术的风险

2022-07-26 xuyihan MedSci原创

胆结石的高危人群主要有: 1、年龄大。胆结石的发病率随着年龄的增长而逐渐增高,因此在40岁以上的中老年人中更常见。 2、女性,与男性相比,女性更容易患胆固醇结石。

胆结石病(GD)的主要危险因素是女性,怀孕,遗传易感因素,避孕和肥胖。迄今为止,肥胖是西方国家的主要公共卫生问题,超过三分之一的美国人是肥胖患者。减肥手术仍然是最好的治疗病态肥胖的手段,众所周知,减肥手术后是胆结石形成和随后的胆道疾病的高危因素(即胆绞痛、胆石性胰腺炎和急性胆管炎)。这种现象是由于胆囊动力不足和继发于胆汁胆固醇饱和度降低。熊去氧胆酸 (UDCA) 可以用于降低减重手术后 GD 高危患者的胆囊切除术的风险。UDCA 是一个抑制胆固醇分泌的次级胆汁酸,从而减少胆固醇结石的形成。UDCA似乎可有效降低胆结石形成的发生率,但其对随后有症状的胆道疾病和胆囊切除术的益处仍有争议。这项荟萃分析旨在比较未经治疗的患者和减肥手术后接受熊去氧胆酸 (UDCA) 治疗的患者的胆结石形成、随后的胆道疾病和胆囊切除术的发生率。

 

 

 

研究人员对使用UDCA的进行减肥手术后的患者进行了随机对照试验 (RCT),并对其进行系统评价和荟萃分析。最后总共纳入了11项随机对照研究,UDCA组共分析了2363名随机患者和2217名患者,而对照组分析了1415名随机患者和1257名患者。

 

研究结果显示,预防性使用 UDCA 与(i)胆结石形成减少相关 (OR=0.25, 95%CI=0.21–0.31), (ii)而且症状性胆结石疾病 (GD)的发生率也会降低 (OR=0.29, 95%CI=0.20–0.42), (iii)而且胆囊切除率也会降低 (OR =0.33, 95% CI=0.20–0.55)。在 ITT 分析中,在接受袖状胃切除术或仅考虑随机与安慰剂研究的患者亚组中结果相似。

 

 

本项研究证实减肥手术后预防性使用 UDCA 可防止胆结石形成和症状性 GD 并减少胆囊切除术的风险。

 

 

 

原始出处:

Andrea Mulliri. et al. Ursodeoxycholic acid for the prevention of gallstones and subsequent cholecystectomy after bariatric surgery: a meta-analysis of randomized controlled trials.Journal of Gastroenterology.2022.

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    2022-08-29 许安
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GetPortalCommentsPageByObjectIdResponse(id=1245949, encodeId=55d512459498b, content=什么时候有懒人用的减肥神药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Jul 24 18:02:51 CST 2022, time=2022-07-24, status=1, ipAttribution=)]
  5. 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GetPortalCommentsPageByObjectIdResponse(id=1245949, encodeId=55d512459498b, content=什么时候有懒人用的减肥神药?, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Jul 24 18:02:51 CST 2022, time=2022-07-24, status=1, ipAttribution=)]
  6. 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    2022-07-26 ms4000001809038213

    学习了

    0

  7. 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  8. 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    2022-07-24 CHANGE

    什么时候有懒人用的减肥神药?

    0

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