缺血后处理对改善心肌缺血再灌注损伤影响的meta分析

彭勇; 刘建清; 郑春华; 范剑峰

doi:10.13201/j.issn.1001-1439.2015.05.011

缺血后处理对改善心肌缺血再灌注损伤影响的meta分析

- 南昌市第一医院心内二科(南昌, 330006)

详细信息

作者简介:
范剑峰,E-mail:390696271@qq.com

中图分类号: R542.2

收稿日期: 2014-09-12

Effects of ischemic postconditioning on myocardial ischemia-reperfusion injury:a meta-analysis

- The Second Department of Cardiology, The First Hospital of Nanchang, Nanchang, 330006, China

Received Date: 12 September 2014

摘要

摘要: 目的:通过meta分析评价缺血后处理对改善心肌缺血再灌注损伤的影响,为临床提供证据。方法:纳入有关选择急性ST段抬高型心肌梗死(STEMI)患者在经皮冠状动脉介入治疗中施行后处理的前瞻性随机对照试验。提取肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、左心室射血分数(LVEF)等观察数据,使用Review Manager 5.1软件进行meta分析。结果:17项随机对照研究符合纳入标准。对纳入文献进行研究分析后,发现在给予急性STEMI患者施行PCI中附加后处理可以明显降低术后CK释放峰值:WMD:469.23 U,95%CI(-622.50,-315.96)(P<0.05);CK-MB释放峰值:WMD 64.71U,95%CI(-91.34,-38.07)(P<0.05);提高LVEF 7d后WMD:4.47%,95%CI(1.27,7.67)(P=0.006)和3个月后WMD:5.85%,95%CI(2.58,9.12)(P=0.0005)。结论:在给STEMI患者施行PCI治疗同时施行缺血后处理,能减少患者的CK和CK-MB释放峰值,提高近期及中长期LVEF。有理由相信临床中对急性STEMI患者在行PCI中施行后处理可以使此类患者获益,但该结果需要更多大型随机对照试验来进一步论证。
- 缺血后处理 /
- 缺血再灌注损伤 /
- 心肌梗死 /
- meta分析
Abstract: Objective:To evaluate current evidence about cardioprotection of ischemic postconditioning(IPC) in patients with ST-segment elevation myocardial infarction(STEMI) undergoing primary percutaneous coronary intervention(PPCI),and provide evidence for clinical choice.Method:Access to PubMed Embase,MEDLINE,Cochrane databases,Wanfang,CNKI,CBM,from January 2005 to January 2012 for finding relevant studies abou ischaemic,data about CK,CK-MB and LVEF were extracted and analyzed by Review Manager 5.1.Result:Seventeen randomized controlled studies met inclusion criteria.Compared to the controls,observed outcomes such as peak CK[WMD:469.23 U,95%CI(-622.50,-315.96) (P<0.05)]and CK-MB[WMD 64.71 U,95%CI(-91.34,-38.07) (P<0.05)]were decreased,while LVEF after 7days[WMD:4.47%,95%CI(1.27,7.67) (P=0.006)]and 3months[WMD:5.85%,95%CI(2.58,9.12) (P=0.0005)]were increased in patients with IPC.Conclusion:Although current evidence shows that IPC provides cardioprotection to patients with STEMI undergoing primary PCI,larger adequately powered studies should be undertaken to confirm its benefit.
- ischemic postconditioning /
- myocardial ischemia reperfusion /
- myocardial infarction /
- meta-analysis

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