尼可地尔治疗经皮冠脉介入术围手术期心肌损伤的系统评价再评价  

Re-evaluation of a systematic review of Nicorandil in the treatment of perioperative myocardial injury after percutaneous coronary intervention

作　　者：邢清梅 张印明 马怀安 韩友峰 XING Qingmei;ZHANG Yinming;MA Huaian;HAN Youfeng(Department of Cardiology,Yankuang New Journey General Hospital,Shandong Province,Zoucheng273500,China;Department of Emergency,Yankuang New Journey General Hospital,Shandong Province,Zoucheng273500,China;Department of Clinical Laboratory,Yankuang New Journey General Hospital,Shandong Province,Zoucheng273500,China)

机构地区：[1]山东省兖矿新里程总医院心内科,山东邹城273500 [2]山东省兖矿新里程总医院急诊科,山东邹城273500 [3]山东省兖矿新里程总医院检验科,山东邹城273500

出　　处：《中国当代医药》2025年第10期139-143,共5页China Modern Medicine

摘　　要：目的再评价尼可地尔治疗经皮冠脉介入(PCI)围手术期心肌损伤(PMI)的系统评价。方法在9个数据库(中国知网、万方数据、维普、中国生物医学文献服务系统、PubMed、Cochrane Library、Web of Science、JBI系统评价和证据应用报告数据库、Campbell协作网)检索尼可地尔治疗PMI的系统评价,检索时限为建库至2023年10月31日。基于文献纳排标准,两名研究员独立筛选和提取文献,应用PRISMA声明、AMSTAR2量表和GRADE工具分别评价纳入文献的报告质量、方法学质量和结局指标的证据质量。结果12篇文献的PRISMA评分介于11.0~23.5分,高、中、低质量报告分别为5篇、6篇、1篇;12篇文献的方法学质量均为极低质量;纳入3个结局指标,包括肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTNI)和左心室射血分数(LVEF),共24个证据体,高、中、低、极低质量证据体分别为1个、10个、6个和7个。系统评价结果显示,尼可地尔对PCI术后CK-MB和cTNI的疗效可能存在获益,尼可地尔可显著提高PCI术后LVEF值(P<0.05)。结论尼可地尔可有效提高PCI术后患者LVEF,对CK-MB和cTNI的疗效可能存在优势,为尼可地尔治疗PMI提供临床指导。Objective To re-evaluate the systematic review of nicorandil for the treatment of periprocedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods The systematic review of Nicorandil treatment PMI was conducted in 9 databases(CNKI,Wanfang Data,VIP,China Biomedical Literature Service System,PubMed,Cochrane Library,Web of Science,JBI systematic review and evidence application reporting database,Campbell collaborative network).The search period was up to October 31,2023.Based on the inclusion criteria,two researchers independently screened and extracted the literatures.PRISMA statement,AMSTAR2 scale and GRADE tool were used to evaluate the reporting quality,methodological quality and evidence quality of outcome indicators of the included literatures,respectively.Results PRISMA scores of the 12 literatures ranged from 11.0-23.5,and the number of high,medium and low quality reports was 5,6 and 1,respectively.The methodological quality of the 12 literatures was very low.Three outcome indicators,including creatine kinase(CK-MB),cardiac troponin I(cTNI)and left ventricular ejection fraction(LVEF)were included,there were 24 evidence bodies,with 1,10,6 and 7 evidence bodies of high,medium,low and very low quality,respectively.The results of systematic review showed that Nicorandil may benefit the efficacy of CK-MB and cTNI after PCI,and Nicorandil can significantly increase the LVEF value after PCI(P<0.05).Conclusion Nicorandil can effectively improve LVEF in patients after PCI,and may have advantages in the efficacy of CK-MB and cTNI,providing clinical guidance for Nicorandil in the treatment of PMI.

关 键 词：尼可地尔 经皮冠脉介入 围手术期心肌损伤 系统评价 META分析 

分 类 号：R542.2[医药卫生—心血管疾病]