Effects of Cyclosporine on Reperfusion Injury in Patients: A Meta-Analysis of Randomized Controlled Trials
Effects of Cyclosporine on Reperfusion Injury in Patients: A Meta-Analysis of Randomized Controlled Trials
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DOI：
10.1155/2015/287058
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发表时间：
2015-01-01
影响因子：
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通讯作者：
Qi, Dake
中科院分区：
文献类型：
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作者：
Song, Kangxing;Wang, Shuxia;Qi, Dake
线粒体通透性过渡孔（mPTP）开放由于其调节ROS生成的作用而导致心脏再灌注损伤。在动物实验中，环孢素（cyclosporine A, CsA），一种mPTP抑制剂，被发现可以预防急性心肌梗死后的再灌注损伤。然而，CsA在临床患者再灌注损伤中的作用尚不清楚。我们使用已发表的临床研究和电子数据库进行了荟萃分析。使用标准化算法提取相关数据，并根据指示直接从调查人员处获取额外数据。我们的荟萃分析纳入了5项随机对照盲法试验。临床结果包括梗死面积（SMD: -0.41; 95% CI: -0.81, 0.01; P = 0.058）、左心室射血分数（LVEF） （SMD: 0.20; 95% CI: -0.02, 0.42; P = 0.079）、肌钙蛋白I (TnI) （SMD: -0.21; 95% CI: -0.49, 0.07; P = 0.149）、肌酸激酶（CK） （SMD: -0.32; 95% CI: -0.98, 0.35; P = 0.352）、肌酸激酶- mb同功酶（CK- mb） (SMD: -0.06; 95% CI: -0.35, 0.23；P = 0.689)提示CsA治疗前后心功能及损伤无显著差异。我们的研究结果表明，与CsA在动物模型中的积极作用不同，CsA给药可能不能保护临床心肌梗死患者的心脏免受再灌注损伤。
Mitochondrial permeability transition pore (mPTP) opening due to its role in regulating ROS generation contributes to cardiac reperfusion injury. In animals, cyclosporine (cyclosporine A, CsA), an inhibitor of mPTP, has been found to prevent reperfusion injury following acute myocardial infarction. However, the effects of CsA in reperfusion injury in clinical patients are not elucidated. We performed a meta-analysis using published clinical studies and electronic databases. Relevant data were extracted using standardized algorithms and additional data were obtained directly from investigators as indicated. Five randomized controlled blind trials were included in our meta-analysis. The clinical outcomes including infarct size (SMD: -0.41; 95% CI: -0.81, 0.01; P = 0.058), left ventricular ejection fraction (LVEF) (SMD: 0.20; 95% CI: -0.02, 0.42; P = 0.079), troponin I (TnI) (SMD: -0.21; 95% CI: -0.49, 0.07; P = 0.149), creatine kinase (CK) (SMD: -0.32; 95% CI: -0.98, 0.35; P = 0.352), and creatine kinase-MB isoenzyme (CK-MB) (SMD: -0.06; 95% CI: -0.35, 0.23; P = 0.689) suggested that there is no significant difference on cardiac function and injury with or without CsA treatment. Our results indicated that, unlike the positive effects of CsA in animal models, CsA administration may not protect heart from reperfusion injury in clinical patients with myocardial infarction.