美沙拉嗪致急性胰腺炎的文献病例分析

Literature analysis of acute pancreatitis caused by mesalazine

目的:探讨美沙拉嗪所致急性胰腺炎的特点和发生规律,为临床安全用药提供参考。方法:检索从建库至2022年12月收录在中国知网、万方、维普、PubMed、Web of Science数据库中美沙拉嗪所致的急性胰腺炎的病例文献,并对相关数据进行整理和统计分析。结果:纳入27篇文献,共31例患者,其中男性17例、女性14例,平均年龄(26.45±11.54)岁。美沙拉嗪所致急性胰腺炎一般发生在用药早期,潜伏期从1 d至2年,其中64.52%的患者同时存在胰酶升高、腹痛、影像学改变,再次用药的患者有94%再发急性胰腺炎,但未出现更严重的胰腺炎。同时,美沙拉嗪所致急性胰腺炎的发生与剂量和合并用药无关。经停药后急性胰腺炎患者恢复快,酶学水平的恢复晚于症状的恢复。结论:在临床使用美沙拉嗪的过程中,急性胰腺炎可能短时间即出现,应注意早期监测和识别,并及早干预,特别是年轻患者。若用药后发生急性胰腺炎,应尽快停药,对症治疗,尽量避免再次使用。

OBJECTIVE To explore the clinical characteristics of acute pancreatitis(AP)caused by mesalazine and provided references for rational drug use in clinic.METHODS Case reports of AP caused by mesalazine were retrieved from the databases of CNKI,Wanfang,VIP,PubMed and Web of Science from inceptions until December 2022.RESULTS A total of 27 litera⁃tures involving 31 patients were obtained.There were 17 males and 14 females with an average age of(26.45±11.54)years.With a latency of 1 day to 2 years,AP caused by mesalazine generally occurred at an early stage.And 64.52%of patients pre⁃sented with elevated pancreatic enzymes,abdominal pain and imaging changes.Among retreated patients,94%experienced a recurrence of AP,but it was not more severe.Meanwhile,AP caused by mesalazine was not correlated with dosage and concomi⁃tant medication.After withdrawing mesalazine,patients always recovered quickly and the normalization of enzyme level was later than the recovery of symptoms.CONCLUSION During mesalazine dosing,AP may occur shortly after initiation.Early monitor⁃ing and timely identification should be implemented with swift interventions,especially in younger patients.If AP occurs,medica⁃tion should be stopped promptly with symptomatic treatment and rechallenging of mesalazine should be avoided if possible.