摘要
目的探讨缺血后处理(I-postC)对接受急诊介入治疗的急性心肌梗死(AMI)患者的心脏保护作用。方法检索1998年1月至2011年5月各中文医学数据库中关于AMI患者接受急诊介入治疗过程中应用I-postC的文献。进行文献筛选和质量评价后,利用RevMan4.2软件进行Meta分析。结果共纳入文献7篇,总病例数为519例,其中I-postC组234例,对照组285例。与对照组比较,I-postC能明显降低AMI患者的肌酸激酶(CK)酶峰(WMD:-356.72IU/L,95%CI:-541.33~-199.11IU/L,P<0.000 01)、肌酸激酶MB型同工酶(CK-MB)酶峰(WMD:-39.45IU/L,95%CI:-54.53~-24.37IU/L,P<0.000 01)以及再灌注心律失常的发生(OR:0.41,95%CI:0.25~0.66,P=0.000 3),并改善AMI患者左心室射血分数(LVEF)(WMD:0.03,95%CI:0.02~0.03,P<0.000 01)。结论 I-postC对缺血心脏有明显的保护作用,具有较大的临床应用价值。
Objective To explore cardioprotective effects of ischemic postconditioning(I-postC) on patients with acute myocardial infarction who had accepted emergency interventional therapy.Methods Literature from January 1998 to May 2011 related to I-postC application in patients with AMI who had accepted emergency interventional therapy were searched in all Chinese medical databases.After literature screening and quality assessment,RevMan 4.2 software was utilized for Meta-analysis.Results A total of 7 literatures were enrolled with total 519 cases.234 cases of them were in I-postC groups and 285 cases in control groups.Compared with control group,I-postC significantly reduced the creatine kinase(CK) peak value(WMD:-356.72 IU/L,95%CI:-514.33——199.11 IU/L,P0.000 01),creatine kinase MB isoenzyme(CK-MB) peak value(WMD:-39.45 IU/L,95%CI:-54.53——24.37 IU/L,P0.000 01) and occurrence of reperfusion-induced arrhythmia(OR:0.41,95%CI:0.25-0.66,P=0.000 3) in patients with AMI.I-postC was also found to improve left ventricular ejection fraction(LVEF) of patients with AMI(WMD:0.03,95%CI:0.02-0.03,P0.000 01).Conclusion I-postC possesses significantly protective effect on ischemic heart with great value in clinical application.
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第9期833-835,839,共4页
Chongqing medicine
基金
上海交通大学附属第一人民医院松江分院院级课题基金资助项目(BY09A08)
关键词
心肌梗死
心律失常
肌酸激酶
Meta分析
缺血后处理
myocardial infarction
arrhythmia
creatine kinase
Meta-analysis
ischemic postconditioning