论文部分内容阅读
目的系统评价肝素治疗吸入性肺损伤动物实验的模型构建过程及其治疗效果。方法计算机检索Pub Med、EMbase、CBM、CNKI、VIP和Wan Fang Data数据库,搜集肝素治疗吸入性肺损伤的动物实验,检索时限均为建库至2016年11月。由2位研究者独立进行文献筛选、资料提取和偏倚风险评价后,采用Rev Man 5.3软件进行Meta分析。结果共纳入9个研究,涉及11个吸入性肺损伤动物实验组。纳入研究以羊或大鼠为实验动物,均在40℃以下环境通过棉质毛巾或松木屑燃烧产生烟雾吸入构建模型。Meta分析结果显示:实验组与对照组的病死率差异无统计学意义[肝素组vs.对照组:RR=0.38,95%CI(0.14,1.05),P=0.06;肝素+DMSO组vs.DMSO组:RR=0.10,95%CI(0.01,1.51),P=0.10]。此外,实验组的肺动脉压[MD=–3.31,95%CI(–4.51,–2.11),P<0.000 01]、肺湿干比[MD=–0.90,95%CI(–1.19,–0.61),P<0.000 01]、肺含水量[MD=–1.18,95%CI(–1.67,–0.70),P<0.000 01]均低于对照组;实验组12 h氧合指数[MD=131.00,95%CI(59.54,202.46),P=0.000 3]、24 h氧合指数[MD=114.00,95%CI(60.56,167.44),P<0.000 1]和48 h氧合指数[MD=46.00,95%CI(20.62,71.38),P=0.000 4]均高于对照组,且差异均具有统计学意义;但两组凝血功能差异无统计学意义。结论当前证据表明,吸入性肺损伤动物模型构建尚缺乏规范方法,肝素治疗吸入性肺损伤动物可降低动物的肺动脉压和肺含水量。受纳入研究数量和质量的限制,上述结论尚需更多高质量研究予以验证。
Objective To systematically evaluate the animal model of heparin-induced inhalation lung injury and its therapeutic effect. Methods The databases of Pub Med, EMbase, CBM, CNKI, VIP and Wan Fang Data were searched by computer. The animal experiments of heparin treatment of inhaled lung injury were collected. The search time was from the database to November 2016. Two independent researchers conducted literature review, data extraction and risk assessment of bias, and Meta-analysis was performed using Rev Man 5.3 software. Results A total of 9 studies were included involving 11 experimental groups of animals with inhalation lung injury. Inclusion of sheep or rats as experimental animals, all below 40 ℃ environment through the cotton towel or pine litter smoke generated smoke inhalation model. Meta analysis showed that there was no significant difference in mortality between the experimental group and the control group [heparin group vs. control group: RR = 0.38,95% CI (0.14,1.05), P = 0.06; heparin + DMSO group vs. DMSO Group: RR = 0.10, 95% CI (0.01, 1.51), P = 0.10]. In addition, the pulmonary wet and dry lung ratio [MD = -0.90, 95% CI (-1.19, -0.61), P <0.001] , P <0.000 01]. The lung water content [MD = -1.18,95% CI (-1.67, -0.70), P <0.000 01] was lower than that of the control group. The oxygenation index of the experimental group was 12 h 95% CI (59.54,202.46), P = 0.0003], oxygenation index 24 h (MD = 114.00, 95% CI 60.56,167.44, P < 95% CI (20.62, 71.38), P = 0.0004] were higher than the control group, and the differences were statistically significant; however, there was no significant difference in coagulation function between the two groups. Conclusions Current evidence indicates that animal models of aspiration lung injury are still lacking in normative methods. Heparin treatment of animals with inhaled lung injury can reduce pulmonary arterial pressure and lung water content in animals. Due to the limited number and quality of studies involved, the above conclusion still needs more high-quality research to be verified.