Zhu Houyong, Xu Xiaoqun, Ding Yu, Zhou Liang, Huang Jinyu
Zhejiang Chinese Medical University Hnagzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2017 Apr;96(15):e6591. doi: 10.1097/MD.0000000000006591.
Prostaglandin E1 (PGE1) is widely used as a pretreatment for myocardial reperfusion injury in animal experiments. However, the cardioprotective effects of PGE1 in patients have not been established. We performed a meta-analysis to investigate whether PGE1 is cardioprotective, based on the reduction of correlative reperfusion injury events (CRIE), major adverse cardiac events (MACE), and biomarker release in patients with ischemia reperfusion injury.
The Medline, EMBASE, and Cochrane databases were searched for randomized clinical trials confirming the effects of PGE1. Two investigators independently selected suitable trials, assessed trial quality, and extracted data.
Six studies in patients undergoing percutaneous coronary intervention (4 studies) and cardiac surgery (2 studies), comprising a total of 445 patients, were included in this review. The results showed that PGE1 reduced the incidence of CRIE (relative ratio 0.4 [95% confidence interval 0.43, 0.95]), the incidence of MACE (0.35 [0.17, 0.70]), and the level of troponin T (standardized mean difference 20.28 [20.47, 20.09]), creatine kinase-MB (-1.74 [-3.21, - 0.27]), interleukin-6 (-1.37 [-2.69, - 0.04]), and interleukin-8 (-2.05 [-2.75, - 1.34]).
PGE1 may have beneficial effects on myocardial reperfusion injury in the clinic.
前列腺素E1(PGE1)在动物实验中被广泛用作心肌再灌注损伤的预处理药物。然而,PGE1对患者的心脏保护作用尚未得到证实。我们进行了一项荟萃分析,以研究基于缺血再灌注损伤患者相关再灌注损伤事件(CRIE)、主要不良心脏事件(MACE)的减少以及生物标志物释放情况,PGE1是否具有心脏保护作用。
检索Medline、EMBASE和Cochrane数据库,查找证实PGE1作用的随机临床试验。两名研究者独立选择合适的试验、评估试验质量并提取数据。
本综述纳入了6项针对接受经皮冠状动脉介入治疗(4项研究)和心脏手术(2项研究)患者的研究,共445例患者。结果显示,PGE1降低了CRIE的发生率(相对比值0.4[95%置信区间0.43,0.95])、MACE的发生率(0.35[0.17,0.70])以及肌钙蛋白T水平(标准化均差20.28[20.47,20.09])、肌酸激酶同工酶MB(-1.74[-3.21,-0.27])、白细胞介素-6(-1.37[-2.69,-0.04])和白细胞介素-8(-2.05[-2.75,-1.34])。
PGE1在临床上可能对心肌再灌注损伤具有有益作用。