Ayoub Mark, Faris Carol, Tomanguillo Julton, Anwar Nadeem, Chela Harleen, Daglilar Ebubekir
Department of Internal Medicine, Charleston Area Medical Center, West Virginia University, Charleston, WV 25304, USA.
Department of General Surgery, Marshall University, Huntington, WV 25755, USA.
Life (Basel). 2024 Apr 19;14(4):526. doi: 10.3390/life14040526.
Peptic ulcer disease (PUD) can cause upper gastrointestinal bleeding (UGIB), often needing esophagogastroduodenoscopy (EGD). Second-look endoscopies verify resolution, but cost concerns prompt research on metoclopramide's efficacy compared to erythromycin.
We analyzed the Diamond Network of TriNetX Research database, dividing UGIB patients with PUD undergoing EGD into three groups: metoclopramide, erythromycin, and no medication. Using 1:1 propensity score matching, we compared repeat EGD, post-EGD transfusion, and mortality within one month in two study arms.
Out of 97,040 patients, 11.5% received metoclopramide, 3.9% received erythromycin, and 84.6% received no medication. Comparing metoclopramide to no medication showed no significant difference in repeat EGD (10.1% vs. 9.7%, = 0.34), transfusion (0.78% vs. 0.86%, = 0.5), or mortality (1.08% vs. 1.08%, = 0.95). However, metoclopramide had a higher repeat EGD rate compared to erythromycin (9.4% vs. 7.5%, = 0.003), with no significant difference in transfusion or mortality.
The need to repeat EGD was not decreased with pre-EGD use of metoclopramide. If a prokinetic agent is to be used prior to EGD, erythromycin shows superior reduction in the need of repeat EGD as compared to metoclopramide.
消化性溃疡病（PUD）可导致上消化道出血（UGIB），常需进行食管胃十二指肠镜检查（EGD）。二次内镜检查可确认出血是否停止，但出于成本考虑，促使人们对甲氧氯普胺与红霉素的疗效进行研究比较。
我们分析了TriNetX研究数据库的钻石网络，将接受EGD检查的PUD所致UGIB患者分为三组：甲氧氯普胺组、红霉素组和未用药组。采用1:1倾向评分匹配法，比较了两个研究组在重复EGD检查、EGD检查后输血情况及1个月内死亡率。
在97040例患者中，11.5%接受了甲氧氯普胺治疗，3.9%接受了红霉素治疗，84.6%未用药。甲氧氯普胺组与未用药组相比，重复EGD检查（10.1%对9.7%，P = 0.34）、输血情况（0.78%对0.86%，P = 0.5）或死亡率（1.08%对1.08%，P = 0.95）均无显著差异。然而，与红霉素组相比，甲氧氯普胺组的重复EGD检查率更高（9.4%对7.5%，P = 0.003），输血情况或死亡率无显著差异。
EGD检查前使用甲氧氯普胺并不能降低重复EGD检查的必要性。如果在EGD检查前使用促动力剂，与甲氧氯普胺相比，红霉素在减少重复EGD检查需求方面表现更优。
Zotero 插件
