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消化道内镜检查前使用胰高血糖素样肽1受体激动剂的安全性系统评价再评价
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| 篇名： | 消化道内镜检查前使用胰高血糖素样肽1受体激动剂的安全性系统评价再评价 |
| TITLE： | Safety of using glucagon-like peptide-1 receptor agonists before gastrointestinal endoscopy：an overview of systematic reviews |
| 摘要： | 目的 系统评价消化道内镜检查前使用胰高血糖素样肽1受体激动剂（GLP-1RA）的安全性。方法检索中国知网、万方数据、维普网、中国生物医学文献数据库、PubMed等中英文数据库，收集消化道内镜检查前使用GLP-1RA的安全性的系统评价和Meta分析，检索时限为建库至2025年9月30日。通过PRISMA2020声明、AMSTAR2量表、ROBIS工具、GRADE工具分别进行报告质量、方法学质量、偏倚风险和证据质量评价，同时利用修正覆盖面积（CCA）定量评价结局指标的文献重叠程度，并对系统评价/Meta分析的定量结果进行综合质量分析。结果共纳入10篇文献。10项研究均存在一定的信息缺陷（15.5～19.5分），且均存在高偏倚风险；9项研究的方法学质量为极低级，1项研究为低级；在证据质量方面，88个结局指标中，1个为中级、28个为低级、59个为极低级；残留胃内容物发生率、误吸发生率、内镜检查中断发生率、重复内镜检查发生率、肠道准备不足发生率以及波士顿肠道准备量表评分的CCA分别为37.30%、35.00%、35.00%、50.00%、29.60%和20.00%。综合质量分析结果显示，与对照组比较，干预组患者的残留胃内容物发生率、内镜检查中断发生率、重复内镜检查发生率均显著升高，胃排空时间显著延长，波士顿肠道准备量表评分显著降低（P＜0.05），但关于GLP-1RA对患者误吸发生率和肠道准备不足发生率影响的研究结果并不一致。结论消化道内镜检查前使用GLP-1RA会增加患者的残留胃内容物、内镜检查中断和重复内镜检查的发生风险，延长胃排空时间，并降低肠道准备质量，但其对患者误吸和肠道准备不足的影响尚存争议。因纳入系统评价/Meta分析的报告质量、方法学质量及证据质量低，且偏倚风险高，故需谨慎解读所得结论。 |
| ABSTRACT： | OBJECTIVE To conduct a systematic review concerning the safety of using glucagon-like peptide-1 receptor agonists （GLP-1RA） before gastrointestinal endoscopy. METHODS Chinese and English databases including CNKI， Wanfang Data， VIP， CBM， and PubMed were searched to collect systematic reviews and meta-analyses on the safety of using GLP-1RA before gastrointestinal endoscopy， with a search period from the inception to September 30， 2025. Report quality， methodological quality， risk of bias， and evidence quality were assessed using the PRISMA 2020 statement， AMSTAR 2 scale， ROBIS tool， and GRADE tool， respectively. Corrected covered area （CCA） was used to quantitatively evaluate the degree of outcome overlap， and a comprehensive quality analysis was performed on the quantitative results of systematic reviews/meta-analyses. RESULTS Ten studies were included. All 10 stu dies had some information deficiencies （15.5-19.5 points）， and were at high risk of bias； 9 studies were extremely low methodological quality， while 1 study was low. In terms of evidence quality， among 88 outcome indexes， there was 1 moderate-level index， 28 low-level indexes， and 59 extremely low-level indexes. The CCA values of the incidence of residual gastric contents， aspiration， endoscopy interruption， repeated endoscopy， inadequate bowel preparation and Boston Bowel Preparation Scale scores were 37.30%， 35.00%， 35.00%， 50.00%， 29.60% and 20.00%， respectively. Results of comprehensive quality analysis showed that compared with the control group， the incidence of residual gastric contents， endoscopy interruption and repeated endoscopy were increased significantly in the intervention group， along with a notably prolonged gastric emptying time and a significantly lower score of Boston Bowel Preparation Scale （ P ＜0.05）. However， the study results regarding the effects of GLP-1RA on the incidence of aspiration and inadequate bowel preparation were inconsistent. CONCLUSIONS The use of GLP-1RA before gastrointestinal endoscopy can increase certain safety risks， including residual gastric contents， endoscopy interruption and repeated endoscopy， prolong gastric emptying time， and reduce the quality of bowel preparation. However， the effects on aspiration and inadequate bowel preparation remain controversial. The reports included in systematic reviews/meta-analyses exhibited low quality in reporting， methodology and evidence， with high risk of bias. Therefore， conclusions should be interpreted with caution. |
| 期刊： | 2026年第37卷第06期 |
| 作者： | 李雨舟；邹淑英；朱湘南；唐梨；李鹏；谢彩霞 |
| AUTHORS： | LI Yuzhou，ZOU Shuying，ZHU Xiangnan，TANG Li，LI Peng，XIE Caixia |
| 关键字： | 胰高血糖素样肽-1受体激动剂；消化道内镜；安全性；系统评价再评价 |
| KEYWORDS： | glucagon-like peptide-1 receptor agonists； gastrointestinal endoscopy； safety； overview of systematic reviews |
| 阅读数： | 3 次 |
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