中国循证医学杂志
中國循證醫學雜誌
중국순증의학잡지
CHINESE JOURNAL OF EVIDENCE-BASED MEDICINE
2010年
2期
203-214
,共12页
缺血预处理%文献评价%缺血再灌注损伤%器官保护%外科手术%移植
缺血預處理%文獻評價%缺血再灌註損傷%器官保護%外科手術%移植
결혈예처리%문헌평개%결혈재관주손상%기관보호%외과수술%이식
Ischemic preconditioning%Literature review%Ischemic reperfusion injury%Organ protection%Surgical operation%Transplantation
目的 对国内外公开发表的有关缺血预处理(ischemic preconditioning,IPC)对器官保护作用的基础与临床研究文献进行统计与分析,了解IPC的历史沿革、临床和基础研究进展,探索器官移植中IPC的作用和机制.方法 计算机检索MEDLINE(1966～2009.8)、EMbase(1974～2009.8)和Cochrane Library(2009年第2期),由两名研究者独立筛选研究IPC的文献,进行分类整理和分析.结果 最终纳入1 398篇文献,其中75%为基础研究,临床研究仅占25%;研究的靶器官73%是心脏和肝脏.近年有关IPC对心脏、脑、脊髓和肝脏干预效应的研究明显增加,但关于IPC干预在心脏和肝外科及移植手术的临床研究则明显滞后于基础研究;IPC对其他器官如肾脏、肺、胃肠及胰腺效应的临床研究也相对较少.结论 IPC对心脏外科及移植相关手术、肝外科手术及活体肝移植、肺普通手术及移植相关手术均有保护效果;IPC可有效减轻中枢神经系统缺血再灌注损伤的程度,但对尸肝移植无保护效果;IPC对肾脏、胃肠道的效应尚不明确.IPC干预对器官的保护效应机制尚无结论.
目的 對國內外公開髮錶的有關缺血預處理(ischemic preconditioning,IPC)對器官保護作用的基礎與臨床研究文獻進行統計與分析,瞭解IPC的歷史沿革、臨床和基礎研究進展,探索器官移植中IPC的作用和機製.方法 計算機檢索MEDLINE(1966～2009.8)、EMbase(1974～2009.8)和Cochrane Library(2009年第2期),由兩名研究者獨立篩選研究IPC的文獻,進行分類整理和分析.結果 最終納入1 398篇文獻,其中75%為基礎研究,臨床研究僅佔25%;研究的靶器官73%是心髒和肝髒.近年有關IPC對心髒、腦、脊髓和肝髒榦預效應的研究明顯增加,但關于IPC榦預在心髒和肝外科及移植手術的臨床研究則明顯滯後于基礎研究;IPC對其他器官如腎髒、肺、胃腸及胰腺效應的臨床研究也相對較少.結論 IPC對心髒外科及移植相關手術、肝外科手術及活體肝移植、肺普通手術及移植相關手術均有保護效果;IPC可有效減輕中樞神經繫統缺血再灌註損傷的程度,但對尸肝移植無保護效果;IPC對腎髒、胃腸道的效應尚不明確.IPC榦預對器官的保護效應機製尚無結論.
목적 대국내외공개발표적유관결혈예처리(ischemic preconditioning,IPC)대기관보호작용적기출여림상연구문헌진행통계여분석,료해IPC적역사연혁、림상화기출연구진전,탐색기관이식중IPC적작용화궤제.방법 계산궤검색MEDLINE(1966～2009.8)、EMbase(1974～2009.8)화Cochrane Library(2009년제2기),유량명연구자독립사선연구IPC적문헌,진행분류정리화분석.결과 최종납입1 398편문헌,기중75%위기출연구,림상연구부점25%;연구적파기관73%시심장화간장.근년유관IPC대심장、뇌、척수화간장간예효응적연구명현증가,단관우IPC간예재심장화간외과급이식수술적림상연구칙명현체후우기출연구;IPC대기타기관여신장、폐、위장급이선효응적림상연구야상대교소.결론 IPC대심장외과급이식상관수술、간외과수술급활체간이식、폐보통수술급이식상관수술균유보호효과;IPC가유효감경중추신경계통결혈재관주손상적정도,단대시간이식무보호효과;IPC대신장、위장도적효응상불명학.IPC간예대기관적보호효응궤제상무결론.
Objective To collect and analyze published experimental and clinical studies about the protective function of ischemic preconditioning(IPC)to organs,in order to learn the history of IPC,the progress of experimental as well as clinical studies,and explore the mechanism of IPC in organ transplantation.Methods The electronic search of MEDLINE(1966 to Aug.2009),EMbase(1974 to Aug,2009)and The Cochrane Library(Issue 2,2009)were performed to include and exclude the retrieved articles by two reviewers independently.The included studies were further treated for analysis and discriptive review.Results A total of 1 398 papers were included,of which about 75 percent were experimental studies,and only about 25 percent were clinical studies.About 73 percent studies focused on the heart and liver.Althrough the studies about the effects induced by IPC on the heart,brain,spinal cord and liver increased obviously in recent years,the clinical studies concerned the heart and liver operation and transplantation still far lagged behind experimental studies,especially very few clinical studies on the effect induced by IPC on kidney,lung,gastrointestinal tract and pancreas.Condusion IPC intervention can effectively protect the heart and lung from the I/RI during the surgical and transplatational operations,and the hepat-surgical and living liver transplantational operations.IPC can effectively protect the brain and spinal cord from I/RI,but no protective function to cadaveric liver transplantation.However,the IPC effects on the kidney and gastrointestinal tract are not confirmed and neither is the mechanism of the effect induced by IPC.
