他汀类药物的使用与内镜逆行胰胆管造影术后胰腺炎风险的关系。

Statin consumption and risk of post-endoscopic retrograde cholangiopancreatography pancreatitis.

机构信息

Gastroenterology Department, Cruces University Hospital, Barakaldo, Vizcaya, Spain.

Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.

出版信息

Pancreatology. 2020 Jul;20(5):801-805. doi: 10.1016/j.pan.2020.05.002. Epub 2020 May 7.

DOI:10.1016/j.pan.2020.05.002

PMID:32448748

Abstract

BACKGROUND

The most frequent complication of endoscopic retrograde cholangiopancreatography (ERCP) is post-ERCP acute pancreatitis (PEP). Statin consumption seems to lower the incidence of acute pancreatitis. We aimed to investigate the relationship between the use of statins and the incidence of PEP.

METHODS

multicenter (4 Spanish tertiary-level public hospitals) retrospective cohort study. Adult patients undergoing an ERCP were included in the study. We excluded patients with chronic pancreatitis, with ongoing acute pancreatitis and those who developed other complications after ERCP. Patients were classified into 2 groups: those under statin treatment (group S) and controls (group C). A multivariate analysis was performed (binary logistic regression) including age, center, female gender, previous pancreatitis, suspected sphincter of Oddi dysfunction, difficult cannulation (>10 min), >1 pancreatic guidewire passages, pancreatic injection, pancreatic stenting and presence of choledocholitiasis.

RESULTS

seven hundred and two patients were included, median age 74 (62-82 years), 330 (47%) females, 223 (32%) in group S. Thirty-five (5%) patients developed PEP, 6 (3%) in group S and 29 (6%) in group C. Statin use was not associated with a lower frequency of PEP in univariate analysis, OR 0.429 (95% confidence interval 0.176-1.05, p = 0.06) or in multivariate analysis, adjusted OR 0.5 (0.19-1.32), p = 0.16. Statin use had no effect on severity of PEP, being mild in 50% vs 78.6% in non-statin users, p = 0.306.

CONCLUSIONS

the chronic use of statins was not associated with a decreased risk of PEP or a milder course of disease in our sample of patients.

摘要

背景

内镜逆行胰胆管造影术（ERCP）最常见的并发症是内镜逆行胰胆管造影术后胰腺炎（PEP）。他汀类药物的使用似乎可以降低胰腺炎的发生率。我们旨在研究他汀类药物的使用与 PEP 发生率之间的关系。

方法

多中心（西班牙 4 家三级公立医院）回顾性队列研究。纳入接受 ERCP 的成年患者。我们排除了患有慢性胰腺炎、正在发生急性胰腺炎以及在 ERCP 后发生其他并发症的患者。患者分为两组：他汀类药物治疗组（组 S）和对照组（组 C）。进行了多变量分析（二项逻辑回归），包括年龄、中心、女性、既往胰腺炎、可疑 Oddi 括约肌功能障碍、困难插管（>10 分钟）、>1 根胰管导丝通过、胰管注射、胰管支架和存在胆总管结石。

结果

共纳入 702 例患者，中位年龄 74（62-82 岁），330 例（47%）为女性，223 例（32%）在组 S。35 例（5%）患者发生 PEP，组 S 中 6 例（3%），组 C 中 29 例（6%）。单因素分析显示，他汀类药物使用与 PEP 发生率降低无关，OR 0.429（95%置信区间 0.176-1.05，p=0.06）或多因素分析调整 OR 0.5（0.19-1.32），p=0.16。他汀类药物使用对 PEP 的严重程度没有影响，50%为轻度，而非他汀类药物使用者为 78.6%，p=0.306。