磷酸肌酸和炎症标志物对二尖瓣置换术的预后价值：一项系统评价和荟萃分析。
Prognostic Value of Creatine Phosphate and Inflammatory Markers for Mitral Valve Replacement: A Systematic Review and Meta-Analysis.
作者信息
Zhu Yanhui, Zou Chengwei, Zhang Jun, Chen Lei, Jia Yanting
机构信息
Department of Cardiac Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021 Shandong, China.
Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021 Shandong, China.
出版信息
Appl Bionics Biomech. 2022 Mar 11;2022:1132452. doi: 10.1155/2022/1132452. eCollection 2022.
PURPOSE
The prognosis of mitral valve replacement is an important clinical issue and may produce unexpected mortality rates if not properly addressed. The postoperative examination results have important prognostic implications. This study was designed to determine the prognostic value of phosphocreatine and inflammatory markers after mitral valve replacement.
METHOD
Comparison and analysis of the data obtained using SPSS software. The computer retrieved PubMed, Science Citation Index (SCI), Embase, VIP, CNKI, CBM, and Wanfang database and manually retrieved randomized controlled trials (RCTs) published at home and abroad on the central muscle protection role of creatine phosphate in heart valve replacement, and the search period was established until February 2018. Two random literature reviewers independently screened the literature and extracted data, using Review Manager (RevMan) (Computer program), version 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, 2014). RevMan software version 5.0 assesses the risk of bias for inclusion in studies. The software performs a meta-analysis of the obtained data.
RESULTS
Ten RCTs with a total of 464 participants were enrolled. The meta-analysis results showed that (1) elevated creatine kinase levels often predict a better prognosis after mitral valve replacement (RR = 1.36, 95% CI: 1.22 to 1.52, < 0.00001), (2) the creatine kinase isoenzyme level in the venous blood of the phosphocreatine group after 24 h of aortic blocking was significantly lower than that in the control group (SMD = -2.90, 95% CI: -5.19 to -0.60, = 0.01), and (3) Troponin I levels were significantly lower in the intravenous creatine group than in the control group 24 h after opening of the aortic block (SMD = -1.49, 95% CI: -2.02 to -0.97, < 0.00001).
CONCLUSIONS
Creatine phosphate and inflammatory factor have good predictive value for the prognosis of mitral valve replacement.
目的
二尖瓣置换术的预后是一个重要的临床问题，若处理不当可能导致意外的死亡率。术后检查结果具有重要的预后意义。本研究旨在确定二尖瓣置换术后磷酸肌酸和炎症标志物的预后价值。
方法
使用SPSS软件对获得的数据进行比较和分析。通过计算机检索PubMed、科学引文索引（SCI）、Embase、维普资讯（VIP）、中国知网（CNKI）、中国生物医学文献数据库（CBM）和万方数据库，并手动检索国内外发表的关于磷酸肌酸在心脏瓣膜置换术中对心肌保护作用的随机对照试验（RCT），检索截止日期为2018年2月。两名随机文献评价者独立筛选文献并提取数据，使用Review Manager（RevMan）（计算机程序）5.3版（北欧 Cochrane 中心，Cochrane 协作网，哥本哈根，2014年）。RevMan软件5.0版评估纳入研究的偏倚风险。该软件对获得的数据进行荟萃分析。
结果
共纳入10项RCT，总计464名参与者。荟萃分析结果显示：（1）二尖瓣置换术后肌酸激酶水平升高往往预示着更好的预后（RR = 1.36，95%CI：1.22至1.52，P < 0.00001）；（2）主动脉阻断24小时后，磷酸肌酸组静脉血中的肌酸激酶同工酶水平显著低于对照组（SMD = -2.90，95%CI：-5.19至-0.60，P = 0.01）；（3）主动脉阻断开放24小时后，静脉注射肌酸组的肌钙蛋白I水平显著低于对照组（SMD = -1.49，95%CI：-2.02至-0.97，P < 0.00001）。
结论
磷酸肌酸和炎症因子对二尖瓣置换术的预后具有良好的预测价值。
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