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首页> 美国卫生研究院文献>Pakistan Journal of Medical Sciences >Early stage effect of ischemic preconditioning for patients undergoing on-pump coronary artery bypass grafts surgery: systematic review and meta-analysis
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Early stage effect of ischemic preconditioning for patients undergoing on-pump coronary artery bypass grafts surgery: systematic review and meta-analysis

机译：缺血预处理对泵上冠状动脉搭桥术患者的早期效果：系统评价和荟萃分析

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>Background: During the on-pump coronary artery bypass grafts surgery, ischemia/reperfusion injury would happen. Ischemia preconditioning could increase the tolerance against subsequent ischemia and reduce the ischemia/reperfusion injury. However the clinical outcomes of the available trials were different. >Methods >: We searched the Cochrane Central Register of Controlled Trials on The Cochrane Library (Issue 3, 2013), the Medline/PubMed and CNKI in March 2013. RevMan 5.1.6 and GRADEprofiler 3.6 were used for statistical analysis and evidence quality assessment. Heterogeneity was evaluated with significance set at P≤0.10. >Results: Eighteen randomized controlled trials were included. There were no differences on in-hospital mortality, postoperative myocardial infarction morbidity between ischemia preconditioning and control groups. The heterogeneity of creatine kinase-MB level 24 hours after surgery was obvious. The differences of 72 hours area under the curve of cardiac troponin T (mean differences of -14.50, 95% confidence interval of -21.71 to -7.28) and troponin I (mean differences -181.79, 95% confidence interval of -270.07 to -93.52) after surgery were observed. >Conclusion >s >: All the 18 trails, the positive and the negative results were equal. The meta-analysis results should be interpreted with caution due to limited effective data. Because of high cost-effectiveness, ischemia preconditioning could not be denied completely. Large-scale randomized studies are needed, with the operation procedures and included criteria being more specific.
机译：>背景：在泵上冠状动脉搭桥术中，会发生缺血/再灌注损伤。缺血预处理可以提高对随后缺血的耐受性，并减少缺血/再灌注损伤。但是，现有试验的临床结果不同。 >方法 >：我们于2013年3月在Cochrane图书馆（2013年第3期），Medline / PubMed和CNKI上搜索了Cochrane对照试验中央登记册。RevMan 5.1.6和GRADEprofiler 3.6用于统计分析和证据质量评估。评价异质性，显着性设置为P≤0.10。 >结果：包括18项随机对照试验。缺血预处理与对照组之间的院内死亡率，术后心肌梗死发病率无差异。术后24小时肌酸激酶-MB水平的异质性很明显。心肌肌钙蛋白T（平均值差异-14.50，95％置信区间-21.71至-7.28）和肌钙蛋白I（平均值差异-181.79，95％置信区间-270.07至-93.52）下72小时面积的差异）手术后进行观察。 >结论 > s >：在所有18条线索中，阳性和阴性结果均相等。由于有效数据有限，因此应谨慎解释荟萃分析结果。由于具有较高的成本效益，因此不能完全否决缺血预处理。需要进行大规模的随机研究，其操作程序和纳入的标准更为具体。

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