Lancet Gastroen Hepatol:吲哚美辛与ERCP后胰腺炎风险

2019-11-27 MedSci MedSci原创

研究认为,与标准的100mg方案相比,200mg吲哚美辛直肠给药不能降低高危患者的胰腺炎风险

尽管吲哚美辛直肠给药能有效降低高危患者内镜逆行胰胆管造影(ERCP)后胰腺炎风险,但最佳剂量尚不清楚。近日研究人员比较两种剂量吲哚美辛直肠给药方案对高危患者ERCP后胰腺炎发生频率和严重程度的影响。

ERCP后胰腺炎高危患者参与研究,随机在ERCP后立即接受2剂量50毫克吲哚美辛栓(标准剂量组)或4剂量50 mg吲哚美辛栓(高剂量组)。研究的主要结果是ERCP后胰腺炎。

1037名患者参与研究,分别接受标准剂量(n=515)或高剂量吲哚美辛(n=522)。在1037例患者中,141例(14%)发生ERCP后胰腺炎,其中标准剂量吲哚美辛组515例中有76例(15%),而高剂量吲哚美辛组522例中有65例(12%,RR=1.19)。观察到19起可能归因于研究药物的不良事件。1037例患者中有14例(1%)出现临床意义的出血,其中标准剂量吲哚美辛组515例患者中有6例(1%),高剂量吲哚美辛组522例患者中有8例(2%)。大剂量吲哚美辛组522例患者中有3例(1%)发生急性肾损伤,而标准剂量组没有发生。标准剂量组1名患者在ERCP后2天出现非ST段抬高心肌梗死。高剂量组1例患者在ERCP后5天发生短暂性脑缺血发作。除ERCP后141例胰腺炎患者外,发生19起严重不良事件,所有患者都需要入院治疗。在30天随访时,未观察到过敏反应或死亡。

研究认为,与标准的100mg方案相比,200mg吲哚美辛直肠给药不能降低高危患者的胰腺炎风险。

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    2020-11-04 howi
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    2020-07-08 许安
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    2019-11-29 gwc384
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