Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Aliment Pharmacol Ther. 2009 Jun 1;29(11):1155-64. doi: 10.1111/j.1365-2036.2009.03991.x. Epub 2009 Mar 3.
Effects of octreotide on post-endoscopic retrograde cholangiopancreatography pancreatitis have been studied in many clinical trials. These trials have yielded inconclusive results. Results of more recent studies using larger doses, however, seem to be more optimistic.
To examine effects of octreotide at different doses on PEP.
A comprehensive search of relevant databases, including Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library and Science Citation Index yielded 18 randomized controlled trials (RCTs). Trials were divided into two groups according to the total dosage of octreotide: <0.5 mg (OCT1), > or =0.5 mg (OCT2). The rate of PEP was analysed using a fixed effect model.
At doses of > or =0.5 mg, octreotide reduced the rate of PEP. In the OCT2 group, analysis revealed a statistically significant difference on PEP between the octreotide group and the controls (3.4% vs. 7.5%, pooled OR = 0.45; 95% CI: 0.28-0.73; P = 0.001, NNT = 25). In the OCT1 group, the rate of PEP was similar between patients receiving octreotide and the controls (7.2% vs. 6.0%, pooled OR = 1.23; 95% CI: 0.80-1.91; P = 0.35).
Octreotide is effective in preventing PEP, but only at sufficient doses (> or =0.5 mg).
奥曲肽对内镜逆行胰胆管造影术后胰腺炎的影响已在许多临床试验中进行了研究。这些试验的结果尚无定论。然而，使用更大剂量的最近研究结果似乎更为乐观。
检查不同剂量奥曲肽对 PEP 的影响。
对包括 Medline、Embase、Cochrane 对照试验注册库、Cochrane 图书馆和科学引文索引在内的相关数据库进行全面检索，共检索到 18 项随机对照试验（RCT）。根据奥曲肽的总剂量将试验分为两组：<0.5mg（OCT1）和≥0.5mg（OCT2）。使用固定效应模型分析 PEP 的发生率。
在≥0.5mg 的剂量下，奥曲肽降低了 PEP 的发生率。在 OCT2 组中，奥曲肽组与对照组之间 PEP 的差异具有统计学意义（3.4%比 7.5%，合并 OR=0.45；95%CI：0.28-0.73；P=0.001，NNH=25）。在 OCT1 组中，接受奥曲肽治疗的患者与对照组之间 PEP 的发生率相似（7.2%比 6.0%，合并 OR=1.23；95%CI：0.80-1.91；P=0.35）。
奥曲肽在预防 PEP 方面有效，但仅在足够剂量（≥0.5mg）时有效。
