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目的:探讨心肌缺血后处理的有效介入时间窗。方法:计算机检索中国期刊全文数据库(CNKI)、万方数据库、中文科技期刊数据库(VIP)、中国生物医学文摘数据库(CBM)和Pubmed,收集关于后处理抗心肌缺血再灌注损伤的现代文献,对符合纳入标准的文献从发表年份、研究对象、样本量、干预措施、结局指标、实验结果等方面进行统计分析。结果:最终纳入19篇文献,中文16篇,英文4篇,临床类研究2篇,动物类研究17篇。动物实验中,干预措施基本以西药缺血后处理(占47%)、典型后处理(占29%)为主。典型后处理的有效介入时间窗,从再灌注早期数分钟内延长到再灌注开启45min时介入仍能起到心脏保护的作用;西药缺血后处理的有效时间窗与介入治疗的药物相关。临床实验研究甚少,目前的干预措施为西药治疗。结论:后处理抗心肌缺血再灌注损伤的有效介入时间窗取决于介入的干预措施。后处理的研究从动物实验到临床研究的转化依旧存在着较大的问题,为推动其临床应用,需要更合理的研究方案,更大的样本量,更为标准的干预措施。
Objective: To investigate the effective time window of myocardial ischemic postconditioning. Methods: The CNKI, Wanfang database, VIP, CBM and Pubmed were searched by computer. The modern literature on post-treatment anti-myocardial ischemia-reperfusion injury was collected. According to the inclusion criteria of the literature from the publication of the year, the study population, sample size, interventions, outcome measures, experimental results and other aspects of statistical analysis. Results: 19 literatures, 16 Chinese, 4 English, 2 clinical studies and 17 animal studies were finally included. In animal experiments, the interventions were mainly Western post-ischemic post-treatment (47%) and typical post-treatment (29%). The effective time window of typical post-treatment, extending from a few minutes early in reperfusion, to cardioprotection after 45min reperfusion was still effective. The effective time window of Western post-ischemic postconditioning was related to interventional drug. Little research on clinical trials, the current intervention for Western medicine. Conclusion: The effective time window for post-treatment anti-myocardial ischemia-reperfusion injury depends on the intervention intervention. Post-processing research There is still a big problem in the transformation from animal experiments to clinical research. To promote its clinical application, more reasonable research programs, larger sample sizes and more standard interventions are needed.