Remote ischemic conditioning for the prevention of contrast-induced acute kidney injury in patients undergoing intravascular contrast administration: a meta-analysis and trial sequential analysis of 16 randomized controlled trials.
Remote ischemic conditioning for the prevention of contrast-induced acute kidney injury in patients undergoing intravascular contrast administration: a meta-analysis and trial sequential analysis of 16 randomized controlled trials.
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远程缺血调理预防接受血管内造影剂给药的患者造影剂诱发的急性肾损伤：16 项随机对照试验的荟萃分析和试验序贯分析
DOI：
10.18632/oncotarget.18106
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发表时间：
2017-10-03
期刊：
影响因子：
--
通讯作者：
Jia RP
中科院分区：
文献类型：
--
作者：
Zhou CC;Yao WT;Ge YZ;Xu LW;Wu R;Gao XF;Song KW;Jiang XM;Wang M;Huang WJ;Zhu YP;Li LP;Zhou LH;Xu ZL;Zhang SL;Zhu JG;Li WC;Jia RP
目的探讨远程缺血预处理（RIC）对血管内造影剂致急性肾损伤（CI-AKI）的影响。方法全面检索Pubmed、Embase和科克伦图书馆，以确定截至2017年3月15日的所有合格研究。采用危险比（RR）和加权均数差及其95%可信区间（CI）评价治疗效果。异质性和统计学显著性分别采用Q检验和Z检验。结果共纳入16项随机对照试验，共2175例患者。与对照组相比，RIC可显著降低CI-AKI的发生率（RR=0.58; 95%CI：0.46，0.74; P < 0.001），这一点在试验序贯分析中得到进一步证实。亚组分析表明，远程缺血预处理（RIPrC）和远程缺血后处理（RIPrC）均具有明显的疗效，围手术期水化可提高RIC的疗效。RIC还显著减少了6个月内的主要不良心血管事件。结论RIC无论是RIPrC还是RIPrB在血管内造影剂应用中均能有效发挥肾脏保护作用，减少相关不良事件的发生。
Objective We conducted this meta-analysis to examine the effect of remote ischemic conditioning (RIC) on contrast-induced acute kidney injury (CI-AKI) in patients undergoing intravascular contrast administrationon. Methods Pubmed, Embase, and Cochrane Library were comprehensively searched to identify all eligible studies by 15th March, 2017. Risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI) were used to examine the treatment effect. The heterogeneity and statistical significance were assessed with Q-test and Z-test, respectively. Results A total of 16 RCTs including 2175 patients were eventually analyzed. Compared with the control group, RIC could significantly decrease the incidence of CI-AKI (RR=0.58; 95% CI: 0.46, 0.74; P < 0.001), which was further confirmed by the trial sequential analysis. Subgroup analyses showed that remote ischemic preconditioning (RIPrC) and remote ischemic postconditioning (RIPoC) were both obviously effective, and perioperative hydration might enhance the efficiency of RIC. RIC also significantly reduced the major adverse cardiovascular events within six months. Conclusion RIC, whether RIPrC or RIPoC, could effectively exert renoprotective role in intravascular contrast administration and reduce the incidence of relevant adverse events.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
3.5
作者：
Chen, Shao Liang;Zhang, Junjie;Kwan, Tak W.
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Kwan, Tak W.
影响因子：
37.8
作者：
Hoole, Stephen P.;Heck, Patrick M.;Dutka, David P.
通讯作者：
Dutka, David P.
DOI：
10.1161/circinterventions.113.000948
发表时间：
2014-04-01
影响因子：
5.6
作者：
Lavi, Shahar;D'Alfonso, Sabrina;Lavi, Ronit
通讯作者：
Lavi, Ronit
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N