摘要
背景 急性胰腺炎是严重的急腹症之一 ,近年来随着对急性胰腺炎病理生理和发病机制认识的深入 ,发现细胞因子特别是血小板活化因子起着重要作用。来昔帕泛是一种具有潜力的血小板活化因子拮抗剂 ,其动物实验已取得可喜成绩 ,因此有必要对其临床随机对照试验进行评价 ,了解来昔帕泛对急性胰腺炎的治疗效果。目的 判断来昔帕泛是否能改变急性胰腺炎的临床进程 ,阻止或治疗器官衰竭 ,降低急性胰腺炎的死亡率。检索策略 计算机检索上消化道和胰腺疾病组登记的RCT及CBM、EMBASE、MEDLINE ,手检 10种中文杂志及会议论文集摘要 ,与研究者联系获得更多相关研究。选择标准 选择研究对象为发病 72小时以内的急性胰腺炎患者 ,试验组采用来昔帕泛治疗 ,对照组采用安慰剂或其他干预措施 ,比较两组死亡率或器官衰竭率的随机对照试验。数据收集与分析两名评价员独立收集数据并对收集所得数据及试验质量进行评价。结果 至 2 0 0 1年共有 3个试验符合纳入标准 ,与对照组比较 ,来昔帕泛有降低早期死亡率 (OR 0 .5 6 ,95 %CI 0 .2 3- 1.38,P =0 .2 )、减少器官衰竭的发生 (OR 0 .34,95 %CI 0 .0 7- 1.6 3,P =0 .18)、促进器官衰竭的恢复 (OR 0 .4 0 ,95 %CI 0 .12 - 1.32 ,P =0 .13)的趋势 ,但均无统计学意义。
Background Acute pancreatitis is one of the most severe acute abdominal conditions. Recently with the understanding of pathophysiology and pathogenesis of acute pancreatitis, cytokines, especially platelet-activating factor (PAF), have been shown to play an important role. Lexipafant is a potent inhibitor of PAF. It has shown exiting results in the animal experiments, so randomized controlled studies are needed to assess the impact of lexipafant for acute pancreatitis. Objectives To determine whether lexipafant can alter the course, prevent or treat organ failure and reduce mortality in acute pancreatitis. Search strategy Electronic databases were searched and reference lists from included studies were also handsearched. Published abstracts from conference proceedings and ten kinds of Chinese medical journals were handsearched for additional citations. Personal contaction with colleagues and experts in the field of pancreatitis was performed to identify potentially relevant trials. Selection criteria Randomized, controlled trials, In which participants went in hospital within 72 hours of belliache episode, comparing lexipafant to placebo or other interventions on organ failure rate or mortality of acute pancreatitis. Data collection and analysis Data related to the clinical outcomes were extracted by two reviewers independently, if there was any divarication , they would have a discussion. Main Results Three studies meet the inclusion criteria up to 2001. Compared with control group, lexipafant had the tendency of reducing the early deaths (odds ratio 0.56, 95% confidence interval 0.23-1.38, P =0.2), accelerating the recovery of organ failure (OR 0.40, 95%CI 0.12-1.32, P =0.13) and reducing the occurrence of new organ failure OR 0 34, but these results had no statistical significance. A large-scale multicentre randomized controlled trial including 1500 patients has been completed in America, but the result has not been published. Reviewers' Conclusions Current evidence couldn't draw the final conclusi
出处
《中国循证医学杂志》
CSCD
2003年第2期108-113,共6页
Chinese Journal of Evidence-based Medicine
