| 中药药物后适应对急性心肌梗死PCI患者再灌注损伤心肌保护作用的Meta分析 |
| |
| 引用本文： | 罗敏,黄力,王伟钢,王颖辉,刘海波,王显.中药药物后适应对急性心肌梗死PCI患者再灌注损伤心肌保护作用的Meta分析[J].辽宁中医杂志,2013(2):240-245. |
| |
| 作者姓名： | 罗敏 黄力 王伟钢 王颖辉 刘海波 王显 |
| |
| 作者单位： | 卫生部中日友好医院;北京王府中西医结合医院;中国人民解放军第八一医院;北京中医药大学附属东直门医院 |
| |
| 摘 要： | 目的:系统评价中药药物后适应(pharmacological postconditioning)对减轻急性心肌梗死患者经急诊PCI后的再灌注损伤的作用。方法:计算机检索关于中药药物后适应对减轻急性心肌梗死患者经急诊PCI后的再灌注损伤作用的随机对照试验(randomized controlled trial,RCT)。文献检索起止时间均从建库至2012年2月。由2名研究者按纳入与排除标准选择文献、提取资料、交叉核对,而后进行Meta分析。结果:共纳入9个RCT。2个RCT的Meta分析示:中药组CK-MB峰值与对照组相比有统计学差异MD=63.91,95%CI(46.74,81.08),P<0.00001]。3个RCT的Meta分析显示:中药组再灌注心律失常发生率低于对照组OR=0.5,95%CI(0.29,0.87),P=0.01]。对PCI术后2 h、24 h、7 d ST段回落率的Meta分析:PCI术后2 hOR=1.22,95%CI(0.75-1.96),P=0.42],中药组与对照组无统计差异。PCI术后24 hOR=2.32,95%CI(1.50-3.58),P=0.0002],PCI术后7 dOR=3.54,95%CI(1.53-8.20),P=0.003],两组间差异有统计学意义。对PCI术后左心室射血分数的影响,中药组与对照组相比有统计学差异MD=-4.26,95%CI(-7.38,-1.15),P=0.007]。在不良事件方面,3个研究的Meta分析,不良事件两组无统计学意义OR=1.46,95%CI(0.54,3.91),P=0.46]。结论:对急性心肌梗死行急诊PCI术患者,术前给予中药治疗,有利于降低CK-MB峰值及再灌注心律失常发生率,并能提高ST段回落率及左心室射血分数。受纳入研究质量与数量限制,上述结果尚待更多高质量研究来证实。
|
| 关 键 词： | 中药药物后适应 心肌缺血再灌注损伤 Meta分析 系统评价 |
Myocardial Protection of Herbal Medicine Pharmacological Postconditioning for Patients with Acute Myocardial Infarction:A Meta-analysis |
| |
| LUO Min,HUANG Li,WANG Weigang,WANG Yinghui,LIU Haibo,WANG Xian.Myocardial Protection of Herbal Medicine Pharmacological Postconditioning for Patients with Acute Myocardial Infarction:A Meta-analysis[J].Liaoning Journal of Traditional Chinese Medicine,2013(2):240-245. |
| |
| Authors: | LUO Min HUANG Li WANG Weigang WANG Yinghui LIU Haibo WANG Xian |
| |
| Institution: | 1.China-Japan Friendship Hospital,Beijing 100029,China; 2.Beijing Royal Integrative Medicine Hospital,Beijing 102209,China; 3.Chinese People’s Liberation Army Eight One Hospital,Nanjing 210002,Jiangsu,China; 4.Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine,Beijing 100700,China) |
| |
| Abstract: | Objective:To systematically evaluate the effect of herbal medicine on reducing ischemia reperfusion injury in patients with acute myocardial infarction after emergency PCI.Methods:A web-based search was performed for relevant studies,CNKI,CBM,VIP,the Cochrane library,Pubmed and EMbase were searched using pharmacological postconditioning,myocardial infarction,ischemia reperfusion injury,PCI,angiography as the |
| |
| Keywords: | from the inception to February 2012 Randomized controlled trials(RCTs)to evaluate the herbal medicine effect on ischemia-reperfusion injury were collected and Meta-analysis was conducted Domain-based evaluation analysis was conducted further Results:Nine studies were identified Pooled analysis of 2 studies demonstrated a significant reduction of peak creatine kinase with TCM relative to standard care The analysis of 3 of the studies showed the rate of reperfusion arrhythmias of the TCM group was lower than that of the control group[ OR=0 5 95%CI(0 29 0 87) P=0 01] The Meta-analysis of the rate of ST-segment fell back after 2 hours 24 hours and 7 days of PCI showed:2 hours after PCI 24 hours after PCI 7 days after PCI A analysis of 2 of the studies showed an improvement of left ventricular ejection fraction with TCM About adverse events two groups were not significant[(OR=1 46 95%CI(0 54 3 91)] Conclusion:Herbal medicine intervention before PCI for acute myocardial infarction patients may help reduce CK-MB peak and reperfusion arrhythmias incidence may improve the ST segment fall-back rate and left ventricular ejection fraction For the limits of included researches quality and quantity the effects of outcomes remain to be determined Key words:pharmacological postconditioning myocardial ischemia reperfusion injury Meta-analysis systematic review |
| 本文献已被 CNKI 等数据库收录！ |
|
