Cyclooxygenase-2 selective inhibitors in preventing post-endoscopic retrograde cholangiopancreatog-raphy pancreatitis and hyperamylasemia
10.3760/cma.j.issn.1007-5232.2016.07.008
- VernacularTitle:环氧酶-2选择性抑制剂在预防内镜逆行胰胆管造影术后胰腺炎、高淀粉酶血症中的作用研究
- Author:
Zhen LIU
;
Jianyu HAO
- Publication Type:Journal Article
- Keywords:
Cyclooxygenase 2;
Cholangiopancreatography,Endoscopic retrograde;
Pancreatitis;
Hyperamylasemia
- From:
Chinese Journal of Digestive Endoscopy
2016;33(7):458-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effects of cyclooxygenase( COX)?2 selective inhibitors on post?endoscopic retrograde cholangiopancreatography ( ERCP ) pancreatitis ( PEP ) and hyperamylasemia for common bile duct stones. Methods A total of 128 patients with normal serum amylase underwent ERCP from June 2014 to February 2015 in our hospital and were given corresponding drugs to prevent PEP.The pa?tients were divided randomly into four groups:combination group( n=33) , celecoxib group( n=34) , nitro?glycerin group(n=32) and control group(n=29). The serum amylase(AMS), C?reactive protein(CRP) and direct bilirubin( Dbil) after ERCP were measured. Abdominal pain was observed, and the incidence of PEP and post?ERCP hyperamylasemia were recorded. Results The incidence of PEP in combination group, celecoxib group were lower than those in nitroglycerin group and the control group ( 3?03%, 2?94% VS 15?63%, 17?24%),but the difference was not statistically significant(P=0?078).The incidence of post?ERCP hyperamylasemia in combination group and celecoxib group were lower than that in the control group ( 3?03%,5?88% VS 31?03%) with statistically significant difference( P=0?003, P=0?010) . There was no significant difference between nitroglycerin group ( 25%) and control group. The abdominal pain grades of combination group and celecoxib group were lower than those in nitroglycerin group and control group with significant difference(P<0?05). Celecoxib may reduce CRP after ERCP(P=0?001) and nitroglycerin may reduce Dbil after ERCP(P=0?016). Conclusion Celecoxib may reduce the incidence of hyperamylasemia and can help to reduce the abdominal pain and inflammatory reactions after ERCP . Nitroglycerin can help to reduce the Dbil after ERCP .