CAJ | 학술논문

目的利用meta分析的方法评价在拟行心脏外科手术（cardiac surgery）的患者中，N-乙酰半胱氨酸（N-acetylcysteine，NAC）术前应用对术后心房颤动（postoperative atrial ifbrillation, POAF）发生的影响。方法应用计算机检索在心脏外科手术前应用NAC预防术后房颤发生的随机对照试验，根据纳入标准和排除标准筛选文献，提取文献资料并做方法学质量评价，最后，采用Review Manager5.1软件进行Meta分析。结果共纳入8个RCT研究，包括578例患者。使用随机效应模型合并，与对照组（安慰剂或常规对照）相比，常规治疗的基础上NAC术前应用显著降低术后房颤的发生[OR=0.58，95%CI为（0.39，0.86）]，P=0.007；但并不缩短患者的住院时间[WMD=-0.09，95%CI为（-0.44，0.26）]，P=0.62，单位：天。结论 NAC明显降低心脏外科术后房颤发生率。但由于纳入的研究数少，且存在一定偏倚风险，因此该结果尚需大样本高质量的随机双盲对照试验的进一步验证。
목적이용meta분석적방법평개재의행심장외과수술（cardiac surgery）적환자중，N-을선반광안산（N-acetylcysteine，NAC）술전응용대술후심방전동（postoperative atrial ifbrillation, POAF）발생적영향。방법응용계산궤검색재심장외과수술전응용NAC예방술후방전발생적수궤대조시험，근거납입표준화배제표준사선문헌，제취문헌자료병주방법학질량평개，최후，채용Review Manager5.1연건진행Meta분석。결과공납입8개RCT연구，포괄578례환자。사용수궤효응모형합병，여대조조（안위제혹상규대조）상비，상규치료적기출상NAC술전응용현저강저술후방전적발생[OR=0.58，95%CI위（0.39，0.86）]，P=0.007；단병불축단환자적주원시간[WMD=-0.09，95%CI위（-0.44，0.26）]，P=0.62，단위：천。결론 NAC명현강저심장외과술후방전발생솔。단유우납입적연구수소，차존재일정편의풍험，인차해결과상수대양본고질량적수궤쌍맹대조시험적진일보험증。
Objective By the way of meta analysis, to evaluate the effect of preoperative use of N-acetylcysteine(NAC) on preventing atrial ifbrillation in patients who undergo cardiac surgery. Method We used computer to screen and retrieve the studies of randomized controlled trials of preoperative NAC therapy verse non-NAC therapy or placebo therapy on prevention of postoperative atrial ifbrillation(POAF)Fetched the data, conduct the quality evaluation of the included studies According to the predefined inclusion and exclusion criteria .At last, performed a meta analysis with Rev Man 5. 1 software. Results 8 studies involving 578patients were included. Using the ifxed-effects model, NAC therapy signiifcantly reduced the incidence of POAF, [OR=0.58,95%CI(0.388,0.86)] P<0.007;but did not signiifcantly reduces the total hospital stay [WMD=-0.09,95%CI(-0.44,0.26)]P=0.62, compared NAC therapy with non-NAC or placebo therapy based on conventional therapy. Conclusion The preoperative use of NAC signiifcantly reduced the incidence of POAF in patients who underwent cardiac surgery. However, due to the limited quantity of the included studies and bias risk ,the results suggest that large-scale and high quality of randomized double blind control trials are needed.