Bayesian Network Meta-analysis of Somatostatin and Protease Inhibitors for the Prevention of Post-ERCP Pancreatitis and Hyperamylase
10.6039/j.issn.1001-0408.2018.08.26
- VernacularTitle:生长抑素及蛋白酶抑制剂用于预防ERCP术后胰腺炎及高淀粉酶血症的贝叶斯网状Meta分析
- Author:
Jiangang CHEN
1
;
Dandan ZHANG
;
Xufeng LYU
;
Yue YANG
Author Information
1. 沈阳药科大学生命科学与生物制药学院
- Keywords:
Bayesian network Meta-analysis;
Somatostatin;
Protease inhibitors;
Post-ERCP pancreatitis;
Post-ERCP hyperamy-lasemia
- From:
China Pharmacy
2018;29(8):1121-1130
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the clinical efficacy of somatostatin and protease inhibitors in the prevention of post-ERCP pancreatitis(PEP)and hyperamylasemia(PEHA). METHODS:Retrieved from databases as Cochrane Library, PubMed,Embase,RCTs about therapeutic efficacy of somatostatin and protease inhibitors in the prevention of PEP were included. EndNote X8 software was used to eliminate duplicate documents,and the quality of included studies was evaluated according to Cochrane System Evaluator Manual version 5.3.3. Bayesian network Meta-analysis was conducted by MCMC method with R 3.4.3 software Gemtc 0.8 program package. Risk of bias was evaluated by using Rev Man 5.3 software,and risk of publication was evaluated by using Stata 14.0 software draws funnel map. RESULTS:A total of 33 RCTs were included,involving 10 576 patients,somatostatin,gabexate,ulinastatin,nafamostat. Network Meta-analysis showed that in the prevention of PEP,the order of curative effect was as follows:somatostatin(intravenous bolus)>nafamostat>ulinastatin>somatostatin(high-dose intravenous drip)>gabexate,somatostatin(low-dose intravenous drip)was ineffective. In the prevention of PEHA,the order of probability being somatostatin(high-dose intravenous drip)>somatostatin(intravenous bolus)>ulinastatin. Only nafamostat was effective in preventing PEP in high-risk patients. CONCLUSIONS:Compared with somatostatin(low-dose intravenous drip)and gabexate,somatostatin(intravenous bolus)and somatostatin(high-dose intravenous drip),ulinastatin,nafamostat can more effectively prevent PEP. Nafamostat cannot prevent PEHA,but can prevent PEP in high risk patients.
