外源性磷酸肌酸对先天性心脏病矫治手术患儿心肌保护效果的Meta分析  

Cardio-protective Effects of Exogenous Creatine Phosphate in Children Undergoing Cardiac Surgery： a Meta-analysis of Randomized Controlled Trials

作　　者：姚允泰[1] 方能新[1] 龚俊松[1] 晏馥霞[1] 李立环[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院麻醉科,100037

出　　处：《麻醉与监护论坛》2012年第5期361-363,共3页Forum of Anesthesia and Monitoring

摘　　要：目的：系统评价相关的随机对照研究以明确外源性磷酸肌酸对行先天性心脏病矫治手术患儿的心肌保护效果。方法：通过电子数据库检索所有研究外源性磷酸肌酸用于先天性心脏病矫治手术患儿的随机对照研究。由两位作者分别提取结果指标（包括术后心肌钙蛋白I水平、心脏自动复跳率、射血分数，正性肌力药物使用情况、机械通气时间），采用RevMan5．0软件进行Meta分析。结果：共纳入6项前瞻性随机对照研究，包括240例患者，其中磷酸肌酸组121例，对照组119例。与对照组相比．磷酸肌酸组患者术后心肌钙蛋白I水平降低（P〈0．01）．升主动脉开放后心脏自动复跳率增加（P〈0．01）．术后心脏射血分数增加（P〈0．05），正性肌力药物使用率降低（P〈0．01）、术后机械通气时间缩短（P〈0．01）。结论：外源性磷酸肌酸对行先天性心脏病矫治手术的患儿具有一定的心肌保护效果。Objective： This study was undertaken to systematically review relevant randomized controlled trials to determine the cardio-protective efficacy of exogenous creatine phosphate （CP） in children undergoing cardiac surgery. Methods： Electronic databases were searched to identify all randomized controlled trials comparing CP-treated and non-CP-treated Control children undergoing cardiac surgery. Two authors independently extracted outcomes data, which included cardiac troponin （cTn）, spontaneous cardiac resuscitation rate after aortic de-clamping, postoperative ejection fraction （EF）, inotropic support requirement and mechanical ventilation （MV） time. Software RevMan 5.0 was utilized to perform the Meta-analysis. Results： Our search yielded 6 studies including 240 patients, 121 of whom were allocated into the CP group, and 119 into the Control （C） group. Compared with Control patients, those randomized into the CP group had lower cTnI level （P〈0.01）, higher spontaneous resuscitation rate （P〈0.01）, higher EF value （P〈0.05）, less requirement for inotropic support （P〈0.01） and shorter MV time （P〈0.01）. Conclusion： This meta-analysis suggested that, CP could elicit some myocardial protection in children undergoing cardiac surgery.

关 键 词：磷酸肌酸 先天性心脏病.心脏手术 META分析 

分 类 号：R654.2[医药卫生—外科学]