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中国急性胰腺炎的现行诊断与治疗:一项真实世界、多中心研究。

Current diagnosis and treatment of acute pancreatitis in China: a real-world, multicenter study.

机构信息

Department of Surgery, The Affiliated Hospital of Qingdao University, Shandong, People's Republic of China.

Department of Surgery, The Affiliated Hospital of Guizhou Medical University, Guizhou, People's Republic of China.

出版信息

BMC Gastroenterol. 2021 May 8;21(1):210. doi: 10.1186/s12876-021-01799-1.

Abstract

BACKGROUND

Efficacy of pancreatic enzyme inhibitors in acute pancreatitis (AP) is unclear in China.

AIMS

We aimed to present the current status of AP and evaluate the efficacy of pancreatic enzyme inhibitors in a larger population in China.

METHOD

A retrospective, cross-sectional, real-world, multicenter analysis of a large dataset of patients presenting with AP from four hospitals of China over a two-year period was performed. Data were collected from the existing clinical records and the patients were grouped into medication group (somatostatin or octreotide or somatostatin and octreotide) and no medication group. Pair wise propensity score matching was performed for comparing somatostatin, octreotide and somatostatin/octreotide. The end points were incidence of disease complications, organ failure, hospitalization duration, and recovery time taken (hours) for serum amylase/serum lipase to normalcy.

RESULTS

A total of 3900 patients were recruited and 2775 patients were included for analysis. A total of 1100, 661, 676 and 338 patients received either somatostatin or octreotide or somatostatin and octreotide or no medication, respectively. The incidence of complications (7.6% vs 13.6%), organ failure (4.5% vs 7.4%), and the instances of entering ICU (9.3% vs 13.3%) were higher in unmedicated group. Complications at discharge (2.91 times), organ failure (2.53 times), and hospitalization stay were higher in octreotide-treated patients compared with somatostatin-treated patients. In comparison to the octreotide group, the serum amylase/lipase recovery time was shorter in the somatostatin group.

CONCLUSION

This real-world study suggested that the use of pancreatic enzyme inhibitors was positively associated with greater clinical efficacy in AP patients and somatostatin might be more effective than octreotide in real-world settings in China.

摘要

背景

胰酶抑制剂在急性胰腺炎(AP)中的疗效在中国尚不清楚。

目的

本研究旨在介绍中国目前 AP 的现状,并评估胰酶抑制剂在更大人群中的疗效。

方法

对中国 4 家医院 2 年来就诊的急性胰腺炎患者的大型数据集进行回顾性、横断面、真实世界、多中心分析。数据来自现有临床记录,将患者分为药物治疗组(生长抑素或奥曲肽或生长抑素联合奥曲肽)和非药物治疗组。采用配对倾向评分匹配比较生长抑素、奥曲肽和生长抑素/奥曲肽的疗效。主要终点为疾病并发症、器官衰竭、住院时间和血清淀粉酶/血清脂肪酶恢复正常所需的时间(小时)。

结果

共纳入 3900 例患者,其中 2775 例患者纳入分析。分别有 1100、661、676 和 338 例患者接受生长抑素、奥曲肽、生长抑素联合奥曲肽或未接受药物治疗。未用药组并发症(7.6%比 13.6%)、器官衰竭(4.5%比 7.4%)和进入 ICU 的发生率(9.3%比 13.3%)更高。与生长抑素组相比,奥曲肽组的并发症(2.91 倍)、器官衰竭(2.53 倍)和住院时间更长。与奥曲肽组相比,生长抑素组血清淀粉酶/脂肪酶恢复时间更短。

结论

本真实世界研究表明,胰酶抑制剂的使用与 AP 患者的临床疗效呈正相关,生长抑素在真实世界环境中可能比奥曲肽更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50bc/8105912/4f8ba711d733/12876_2021_1799_Fig1_HTML.jpg

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