Role of osmolality of contrast media in the development of post-ERCP pancreatitis: A metanalysis
Role of osmolality of contrast media in the development of post-ERCP pancreatitis: A metanalysis
复制标题
DOI：
10.1023/b:ddas.0000020511.98230.20
复制
发表时间：
2004-03-01
影响因子：
3.1
通讯作者：
Draganov, P
中科院分区：
文献类型：
--
作者：
George, S;Kulkarni, AA;Draganov, P
对比剂渗透压(CM)在ERCP术后胰腺炎(PEP)发生中的作用进行了讨论。因此，我们进行了荟萃分析，以确定渗透压是否影响PEP的发生率。使用计算机化的数据库和对摘要和文章书目的人工搜索来进行英语研究的文献搜索。研究对象为随机对照试验，比较高渗透压造影剂(HOCM)和低渗透压造影剂(LOCM)的PEP发生率。评估的结果是临床胰腺炎，胰腺酶升高和疼痛都是证据。数据用Logistic回归进行分析，包括研究条件和渗透压。费舍尔的精确测试是为了比较PEP比率。在Logistic回归模型中，研究效应的不显著表明研究之间的同质性。Logistic回归分析显示，两组PEP发生率差异无统计学意义(P=0.399)。用Fisher‘s Exact检验比较两组患者的PEP率，在任何个体研究中均未发现差异(所有P值均为0.05)。由于研究样本量的差异很大，我们通过创建三个研究组来重复分析。渗透压的影响与数据的组合方式无关。荟萃分析的结果表明，HOCM和LOCM在临床PEP方面没有显著差异。
The role of osmolality of contrast media (CM) in the development of post-ERCP pancreatitis (PEP) is debated. We therefore performed a metanalysis to determine whether osmolality affects the incidence of PEP. A literature search of English-language studies was performed using computerized databases and manual searching of abstracts and article bibliographies. Randomized controlled trials comparing the incidence of PEP associated with high- and low-osmolality contrast media (HOCM, LOCM) were considered. The outcome assessed was clinical pancreatitis as evidenced by both elevation of pancreatic enzymes and pain. Data were analyzed using logistic regression with terms for study and osmolality. Fisher's exact test was done to compare PEP rates. Homogeneity between studies was indicated by the nonsignificance of the study effect in the logistic regression model. Logistic regression also indicated no difference in PEP rates between LOCM and HOCM (P=0.399). Comparison of PEP rates in both groups using Fisher's exact test did not indicate a difference in any individual study (all P values >0.05). Due to the large variation of study sample sizes, we repeated the analysis by creating three study groups. The effect of osmolality was invariant to how the data were combined. The results of this metanalysis indicate that there is no significant difference between HOCM and LOCM with respect to clinical PEP.