盐酸戊乙奎醚对体外循环心脏手术缺血再灌注心肌保护作用的Meta分析  

Meta-analysis of the myocardial protective effect of pentylenethyclidine hydrochloride on ischemia-reperfusion during cardiopulmonary bypass cardiac surgery

作　　者：代晶[1] 潘道波[1] 王先学 DAI Jing;PAN Daobo;WANG Xianxue(Department of Anesthesiology,the First People′s Hospital of Changde,Hunan Province,Changde 415003,China)

机构地区：[1]湖南省常德市第一人民医院麻醉科,415003

出　　处：《临床合理用药杂志》2023年第26期5-9,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的采用Meta分析评价盐酸戊乙奎醚对体外循环(CPB)心脏手术缺血再灌注心肌的保护作用。方法通过计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台、维普网,内容为CPB心脏手术中使用盐酸戊乙奎醚的随机对照研究(RCTs),检索时间为建库至2021年11月,采用RevMan 5.3软件对收集的资料进行Meta分析。结果纳入研究12项,患者464例,其中盐酸戊乙奎醚组239例,对照组225例。与对照组比较,盐酸戊乙奎醚组术后24 h[WMD=-0.37,95%CI(-0.49~-0.24),P<0.00001]及术后48 h[WMD=-0.98,95%CI(-1.38~-0.58),P<0.00001]心肌肌钙蛋白I(cTnI)水平显著降低;盐酸戊乙奎醚组术后24 h[WMD=-22.13,95%CI(-29.40~-14.86),P<0.00001]及CPB停止即刻[WMD=-24.62,95%CI(-33.02~-16.22),P<0.00001]肌酸激酶同工酶(CK-MB)水平显著降低;主动脉开放30 min,2组cTnI及CK-MB水平比较差异均无统计学意义(P>0.05)。结论盐酸戊乙奎醚能降低CPB心脏手术患者cTnI及CK-MB水平,对缺血再灌注心肌具有保护作用。Objective To evaluate the myocardial protective effect of pentylenethyclidine hydrochloride on ischemia-reperfusion during CPB cardiac surgery by Meta-analysis.Methods RCTs on the use of pentylenethyclidine hydrochloride in CPB cardiac surgery was conducted through computer retrieval of CNKI,CBM,Wanfang database,and VIP database,the retrieval time was from the establishment of the database to November 2021,and the Meta-analysis were performed by RevMan 5.3 software.Results There were 12 studies included,with 464 patients,there were 239 cases in the pentylequidine hydrochloride group and 225 cases in the control group.Compared with the control group,the pentylequidine hydrochloride group showed significant decrease in cTnI levels at 24 hours post surgery[WMD=-0.37,95%CI(-0.49~-0.24),P<0.00001]and 48 hours post surgery[WMD=-0.98,95%CI(-1.38~-0.58),P<0.00001];The levels of CK-MB in the pentylequidine hydrochloride group significantly decreased at 24 hours after surgery[WMD=-22.13,95%CI(-29.40~-14.86),P<0.0001]and immediately after CPB cessation[WMD=-24.62,95%CI(-33.02~-16.22),P<0.00001];After 30 minutes of aortic opening,there was no statistically significant difference in cTnI and CK-MB levels between the two groups(P>0.05).Conclusion Penehyclidine hydrochloride can lower cTnI and CK-MB during CBP cardiac surgery and produce protective effect for ischemia reperfusion myocardium.

关 键 词：盐酸戊乙奎醚 体外循环 心脏手术 缺血再灌注 META分析 

分 类 号：R654.2[医药卫生—外科学]