乌司他丁预防内镜逆行胰胆管造影术后胰腺炎的循证学评价

Evidence-Based Evaluation of Urinastatin in Prevention of Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis

目的:通过快速卫生技术评估(HTA),评价乌司他丁预防内镜逆行胰胆管造影术后胰腺炎的临床应用有效性、安全性和经济性,提供循证证据。方法:计算机检索PubMed、Embase、the Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库和HTA机构官方网站,收集乌司他丁用于预防内镜逆行胰胆管造影术后胰腺炎方面的系统评价/Meta分析、经济学评价和HTA报告,检索区间为建库至2022年12月。2名研究者根据纳入与排除标准独立进行筛选、质量评价和数据提取,并分析数据结果。结果:共纳入10项研究,包括8项系统评价/Meta分析和2项经济学研究,未检索到HTA报告。在有效性方面,乌司他丁预防内镜逆行胰胆管造影术后胰腺炎的发生具有明显的效果,有效性与剂量有明确的正相关性,与其他阳性药物(生长抑素及加贝酯)的疗效基本一致,安全性良好。就目前的价格而言,乌司他丁对比进口或合资阳性药物具有明显的经济学优势。结论:乌司他丁在预防内镜逆行胰胆管造影术后胰腺炎方面有明显效果,安全性良好,经济学方面受不同企业产品价格差异影响暂无法确定,有待进一步研究。

OBJECTIVE:To evaluate the efficacy,safety and economy of urinastatin in the clinical application of post endoscopic retrograde cholangiopancreatography pancreatitis based on rapid health technology assessment(HTA),so as to provide evidence-based medical evidence.METHODS:PubMed,Embase,the Cochrane Library,CNKI,Wanfang Data,CBM and official website of HTA were retrieved to collect the systematic review/Meta-analysis,economic evaluation and HTA report of urinastatin in prevention of post endoscopic retrograde cholangiopancreatography pancreatitis,the retrieval time was from the establishment of the database to Dec.2022.Two researchers independently screened literature,evaluated quality,and extracted data according to the inclusion and exclusion criteria,and the data results were analyzed.RESULTS:A total of 10 studies were enrolled,including 8 systematic review/Meta-analysis,2 economic studies,and no HTA report was retrieved.In terms of effectiveness,urinastatin had obvious therapeurinastatinc effect in the treatment of post endoscopic retrograde cholangiopancreatography pancreatitis,and there was a clear positive correlation between efficacy and dose.Compared with other positive drugs(somatostatin and gabester),the efficacy was basically the same with good safety.At current prices,urinastatin had significant economic advantages over imported or joint-venture positive drugs.CONCLUSIONS:Urinastatin is significantly effective in the treatment of post endoscopic retrograde cholangiopancreatography pancreatitis with higher safety,and in terms of economics,it can not be determined temporarily due to the difference in product prices of different enterprises,which needs to be further investigated.