Liang Yuan-yuan, Zheng Hong, Chen Chun-ling, Guo Hai
Department of Anesthesiology, The First Teaching Hospital of Xinjiang Medical University, Urumqi 830054, China.
Zhonghua Wai Ke Za Zhi. 2012 Nov;50(11):1021-6.
To assess the effect of perioperative glucose-insulin-potassium (GIK) infusions on the prognosis in patients undergoing coronary artery bypass grafting.
Electronic databases including Cochrane library (Issue 3, 2011), Pubmed, EMbase, Highwire, CBM and CNKI were searched. A meta-analysis of all randomized controlled trials (RCTs) comparing GIK with control in coronary artery bypass grafting was performed. Study selection and meta-analysis were conducted which according to the Cochrane Handbook for systematic reviews. Date were extracted from these trials by 3 reviewers independently and analyzed by RevMan5.0 software.
A total of 9 RCTs including 1029 patients were assessed in this study. GIK infusion was associated with significantly fewer perioperative myocardial infarctions (RR = 0.59, 95%CI: 0.38 - 0.91, P = 0.02), less inotropic support requirement (RR = 0.44, 95%CI: 0.35 - 0.56, P < 0.01), and increase the incidence of postoperative atrial fibrillation (RR = 1.23, 95%CI: 1.05 - 1.43, P = 0.009).
GIK significantly reduces myocardial injury and improves cardiac function in patients undergoing coronary artery bypass grafting, but also increases the incidence of postoperative atrial fibrillation.
评估围手术期输注葡萄糖-胰岛素-钾（GIK）对冠状动脉旁路移植术患者预后的影响。
检索电子数据库，包括Cochrane图书馆（2011年第3期）、Pubmed、EMbase、Highwire、中国生物医学文献数据库（CBM）和中国知网（CNKI）。对所有比较冠状动脉旁路移植术中GIK与对照组的随机对照试验（RCT）进行荟萃分析。根据Cochrane系统评价手册进行研究选择和荟萃分析。由3名研究者独立从这些试验中提取数据，并使用RevMan5.0软件进行分析。
本研究共评估了9项RCT，包括1029例患者。输注GIK与围手术期心肌梗死显著减少相关（RR = 0.59，95%CI：0.38 - 0.91，P = 0.02），对血管活性药物支持的需求减少（RR = 0.44，95%CI：0.35 - 0.56，P < 0.01），并增加了术后房颤的发生率（RR = 1.23，95%CI：1.05 - 1.43，P = 0.009）。
GIK可显著减轻冠状动脉旁路移植术患者的心肌损伤并改善心功能，但也增加了术后房颤的发生率。
