Jeurnink S M, Nijs M M, Prins H A B, Greving J P, Siersema P D
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.
Pancreatology. 2015 May-Jun;15(3):203-8. doi: 10.1016/j.pan.2015.03.009. Epub 2015 Apr 8.
To assess the efficacy of antioxidants in acute (AP) pancreatitis.
We searched PubMed, Embase and the Cochrane library for all randomized controlled trials (RCT) involving administration of antioxidants in the therapy of AP until February 2012. AP studies were pooled to analyze the effect of antioxidants on hospital stay, mortality, and complications. Subgroup analyses were performed on the use of the antioxidant glutamine.
In total, eleven RCTs were included. Among patients with AP, antioxidant therapy resulted in a borderline significant reduction in hospital stay (mean difference -1.74; 95%CI -3.56 to 0.08), a significant decrease in complications (RR 0.66; 95%CI 0.46-0.95) and a non-significant decrease in mortality rate (RR 0.66; 95%CI 0.30-1.46). Subgroup analyses showed that glutamine significantly reduced complications (RR 0.51; 95%CI 0.34-0.78) and mortality rate (RR 0.33; 95%CI 0.13-0.85).
The present meta-analysis shows a possible benefit of glutamine supplementation in patients with acute pancreatitis. However, large randomized trials are needed to confirm these observations.
评估抗氧化剂在急性胰腺炎（AP）治疗中的疗效。
我们检索了PubMed、Embase和Cochrane图书馆，查找截至2012年2月所有涉及在AP治疗中使用抗氧化剂的随机对照试验（RCT）。汇总AP研究以分析抗氧化剂对住院时间、死亡率和并发症的影响。对抗氧化剂谷氨酰胺的使用进行亚组分析。
总共纳入了11项RCT。在AP患者中，抗氧化剂治疗使住院时间有临界显著缩短（平均差 -1.74；95%CI -3.56至0.08），并发症显著减少（RR 0.66；95%CI 0.46 - 0.95），死亡率无显著降低（RR 0.66；95%CI 0.30 - 1.46）。亚组分析表明，谷氨酰胺显著降低了并发症（RR 0.51；95%CI 0.34 - 0.78）和死亡率（RR 0.33；95%CI 0.13 - 0.85）。
本荟萃分析显示补充谷氨酰胺对急性胰腺炎患者可能有益。然而，需要大型随机试验来证实这些观察结果。
