Antioxidant drugs to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis:What does evidence suggest?  

作　　者：Clotilde Fuentes-Orozco Carlos Davalos-Cobian Jesus Garcia-Correa Gabriela Ambriz-Gonzalez Michel Dassaejv Macias-Amezcua Jesus Garcia-Renteria Jorge Rendon-Felix Mariana Chavez-Tostado Lizbeth Araceli Cuesta-Marquez Andrea Socorro Alvarez-Villasenor Ana Olivia Cortes-Flores Alejandro Gonzalez-Ojeda 

机构地区：[1]Research Unit in Clinical Epidemiology,Specialties Hospital of the Western Medical Center,Medical Unit of High Specialty,Mexican Institute of Social Security, Guadalajara, Jalisco 44340, Mexico [2]Department Gastrointestinal Endoscopy,Specialties Hospital of the Western Medical Center,Medical Unit of High Specialty,Mexican Institute of Social Security, Guadalajara, Jalisco 44340, Mexico [3]Department of Pediatric Surgery.Children’s Hospital.Western National Medical Center,Mexican Institute of Social Security, Guadalajara, Jalisco 44340, Mexico [4]Health Research Coor-dination.Mexican Institute of Social Security ,Baja Californa Sur 23000, Mexico

出　　处：《World Journal of Gastroenterology》2015年第21期6745-6753,共9页世界胃肠病学杂志（英文版）

摘　　要：AIM:To determine whether or not the use of antioxidant supplementation aids in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis.METHODS:A systematic review of randomized controlled trials(RCTs) was made to evaluate the preventive effect of prophylactic antioxidant supplementation in post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP).The inclusion criteria included:acute post-endoscopic retrograde cholangiopancreatography pancreatitis in adults; randomized clinical trials with the use of any antioxidant as an intervention compared with placebo,to reduce PEP.The outcome measure was the incidence and severity of PEP.Twelve RCTs involving 3110 patients since 1999 wereincluded.The antioxidants used were selenite,β-carotene,and pentoxifylline(each one in one trial),N-acetylcysteine(NAC) in three trials,and allopurinol in six trials.The group of patients treated with NAC received different doses; either oral or intravenous,and allopurinol-treated patients received five different oral doses in two different administration periods.The results are expressed with raw numbers,proportions,as well as mean and standard deviations.The incidence of pancreatitis between groups was analyzed with Pearson's χ2 test or Fisher's exact test(F).The main outcome is expressed as relative risks and 95%CI.RESULTS:The incidence of pancreatitis in all antioxidant treatment groups was 8.6%,whereas it was 9.7% in the control group.The antioxidants used were selenite,β-carotene,and pentoxifylline(each one in one trial),NAC in three trials,and allopurinol in six trials.In allopurinol trials,three different dosifications were used; two trials reported a low dosage(of less than 400 mg),two trials reported a moderate dose(600 mg) and the remaining two employed higher doses(more than 900 mg).Supplementation was not associated with a significant reduction in the incidence of PEP [relative risk(RR) = 0.93; 95%CI:0.82-1.06; P = 0.28].In addition,the incidences of PEP in patients treated with allopurAIM:To determine whether or not the use of antioxidant supplementation aids in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis.METHODS:A systematic review of randomized controlled trials(RCTs) was made to evaluate the preventive effect of prophylactic antioxidant supplementation in post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP).The inclusion criteria included:acute post-endoscopic retrograde cholangiopancreatography pancreatitis in adults; randomized clinical trials with the use of any antioxidant as an intervention compared with placebo,to reduce PEP.The outcome measure was the incidence and severity of PEP.Twelve RCTs involving 3110 patients since 1999 wereincluded.The antioxidants used were selenite,β-carotene,and pentoxifylline(each one in one trial),N-acetylcysteine(NAC) in three trials,and allopurinol in six trials.The group of patients treated with NAC received different doses; either oral or intravenous,and allopurinol-treated patients received five different oral doses in two different administration periods.The results are expressed with raw numbers,proportions,as well as mean and standard deviations.The incidence of pancreatitis between groups was analyzed with Pearson's χ2 test or Fisher's exact test(F).The main outcome is expressed as relative risks and 95%CI.RESULTS:The incidence of pancreatitis in all antioxidant treatment groups was 8.6%,whereas it was 9.7% in the control group.The antioxidants used were selenite,β-carotene,and pentoxifylline(each one in one trial),NAC in three trials,and allopurinol in six trials.In allopurinol trials,three different dosifications were used; two trials reported a low dosage(of less than 400 mg),two trials reported a moderate dose(600 mg) and the remaining two employed higher doses(more than 900 mg).Supplementation was not associated with a significant reduction in the incidence of PEP [relative risk(RR) = 0.93; 95%CI:0.82-1.06; P = 0.28].In addition,the incidences of PEP in patients treated with allopur

关 键 词：Antioxidant drugs Endoscopic retrograde cholangiopancreatography PANCREATITIS PROPHYLAXIS 

分 类 号：R576[医药卫生—消化系统]