川芎嗪注射液在体外循环心脏手术中应用的Meta分析  

The Meta Analysis of the Application of Tetramethylpyrazine in Heart Operation for Cardiopulmonary Bypass

作　　者：马敬[1] 忻元峰[2] 李铁岩[2] 郭建华[1] 周莹[1] 丁婷[1] 戚晟雯 

机构地区：[1]同济大学附属东方医院外科监护室,上海200123 [2]同济大学附属东方医院心外科,上海200123

出　　处：《湖北民族学院学报（医学版）》2016年第2期22-26,30,共6页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的评价中药川芎嗪注射液,在体外循环心脏手术中心肌、肺和脑细胞保护作用。方法制定原始文献的纳入标准及检索策略,计算机检索中国期刊全文数据库、中国生物医学文献数据库、维普中文科技期刊全文数据库与万方医学数据库,提取有关体外循环心脏手术病例资料中,试验组干预措施为川芎嗪注射液的随机对照研究(RCT)文献,评价纳入研究的文献质量,并提取有效数据后采用Rev Man 5.3软件进行Meta分析。结果纳入研究的17篇文献,共计547例符合纳入标准。Meta分析结果显示:川芎嗪组与对照组比较,自动复跳率川芎嗪组为68/87(78.16%),对照组为44/87(50.57%)。OR值及其95%CI为4.22(2.03~8.76),P=0.000 1;呼吸指数(RI)加权均数差(MD)值-0.18(-0.23^-0.14),P<0.000 01;氧合指数(OI)加权均数差(MD)值53.05(42.86~63.23),P<0.000 01;简易智力状态测试(MMSE)测试结果加权均数差(MD)值1.42(0.15~2.68),P=0.03;血肌酸磷酸激酶(CK)检测结果加权均数差(MD)值-332.07(-446.28^-317.86),P<0.000 01;丙二醛(MDA)检测结果加权均数差(MD)值-1.49(-2.31^-0.67),P=0.000 4。结论川芎嗪注射液在体外循环心脏手术中应用,其心肌、肺和脑组织功能保护作用功效优于单纯常规方法。Objective To evaluate the effect of Tetramethylpyrazine（ TMP） forthe myocardium,lung and brainin heart operation for Cardiopulmonary Bypass（ CPB）.Methods The standards and policies of the literature retrievalwere developed.We searched the literatures of patients who suffered heart operation for CPB in the database,such as CNKI,the Chinese Biomedical Literature Database,the China Science and Technology Journal Database and Wanfan Med Online.The test group contained the literatures which involved TMP intervention in randomized controlled trial（ RCT）.After the evaluation of the literatures,the valid data was extracted and analyzed by software Rev Man 5.3.Results 17 literatures were accepted including 547 patients who met the standard.The test group was involved in the TMP intervention.The test results were shown in the weighted mean difference.The results of Meta-analysis were shown as follow：The automatic resuscitation was 68 /87（ 78.16%）,comparing with the contrast group which had the result 44 /87（ 50.57%）（ P〈0.01）.The ORand 95% CI was 4.22（ 2.03 ~ 8.76）.The respirator index（ RI） was-0.18（-0.23 ^-0.14）（ P〈 0.01）.The oxygenation index（ OI） was-332.07（-446.28^-317.86）（ P〈0.01）.The Mini-Mental State Exam（ MMSE） was 1.42（ 0.15 ~ 2.68）（ P〈0.05）.The Malondialdehyde（ MDA） was-1.49（-2.31 ^-0.67）（ P〈0.01）.All the results had the statistical significance.Conclusion During the heart operation for CPB,the TMP performed better protection of the myocardium,lung and brain than the routine method.

关 键 词：川芎嗪 体外循环 心脏手术 META分析 

分 类 号：R654.2[医药卫生—外科学]