Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085, Budapest, Hungary.
University Pharmacy Department of Pharmacy Administration, Hőgyes Endre utca 7-9, 1092, Budapest, Hungary.
Sci Rep. 2022 Oct 26;12(1):17979. doi: 10.1038/s41598-022-22341-7.
Currently, there is no specific pharmaceutical agent for treating acute pancreatitis (AP). Somatostatin and its analogues have been used to prevent the autolysis of the pancreas in AP, however, their effectiveness has not been confirmed. This investigation aimed to examine the efficacy of ulinastatin, a protease inhibitor, combined with somatostatin analogues in the treatment of AP. We conducted a systematic database search in 4 databases to identify randomized controlled trials in which the efficacy of ulinastatin in combination with somatostatin analogue was compared to somatostatin analogue alone in patients with AP. Since the patient populations of analysed papers were slightly different, we used random effect models to pool odds ratios (OR) and mean differences (MD) and the corresponding 95% confidence intervals (CI). A total of 9 articles comprising 1037 patients were included in the meta-analysis. The combination therapy significantly reduced the complication rates for acute respiratory distress syndrome, acute kidney injury, and multiple organ dysfunction. Symptoms were relieved threefold with the combination therapy compared to somatostatin alone, and combination therapy significantly shortened the length of hospital stay. The decrease in mortality was not statistically significant..
目前，尚无治疗急性胰腺炎（AP）的特效药物。生长抑素及其类似物已被用于预防 AP 时胰腺的自溶，但疗效尚未得到证实。本研究旨在探讨蛋白酶抑制剂乌司他丁联合生长抑素类似物治疗 AP 的疗效。我们在 4 个数据库中进行了系统的数据库检索，以确定将乌司他丁联合生长抑素类似物与生长抑素类似物单独用于 AP 患者的疗效进行比较的随机对照试验。由于分析论文的患者人群略有不同，我们使用随机效应模型来汇总优势比（OR）和均数差值（MD）及其相应的 95％置信区间（CI）。共有 9 篇文章纳入了 1037 例患者的荟萃分析。联合治疗可显著降低急性呼吸窘迫综合征、急性肾损伤和多器官功能障碍的发生率。与单独使用生长抑素相比，联合治疗可使症状缓解三倍，并且联合治疗显著缩短了住院时间。死亡率的降低没有统计学意义。
