围术期泵注右美托咪定对肾移植受者术后肾功能影响的Meta分析

Effect of perioperative infusion of dexmedetomidine on postoperative renal function recovery in kidney transplant recipients:a systematic review and Meta analysis

目的:右美托咪定是否能改善肾移植(kidney transplantation,KT)患者肾功能尚存在争议。本文对围术期泵注右美托咪定与肾移植受者术后肾功能恢复的关系进行了Meta分析。方法:检索知网、万方、Pubmed、Embase、Cochrane、Web of Science等数据库,搜集关于围手术期泵注右美托咪定对肾移植受者术后肾功能恢复影响的临床研究。筛选出的主要评价指标是移植物功能延迟恢复(delayed graft function,DGF)、急性肾移植排斥反应(acute renal transplant rejection,ARTR)、感染。各项筛选出的评价指标采用随机效应模型进行Meta分析,异质性检验采用I 2检验,发表偏倚采用漏斗图检验。结果:总共7篇文献(其中6篇为随机对照试验,1篇为回顾性研究),共1223例患者纳入本篇Meta分析。与对照组相比,实验组在DGF[OR=0.71,95%CI(0.52,0.97)]、感染[OR=0.51,95%CI(0.33,0.78)]、术后第2天血肌酐[MD=-0.21,95%CI(-0.37,-0.06)]、住院时间[MD=-0.87,95%CI(-1.61,-0.13)]获得明显改善。结论:围术期泵注右美托咪定可能有助于减少肾移植患者术后的缺血再灌注损伤。

Objective:There is a controversy regarding whether dexmedetomidine can improve renal function in postoperative kidney transplant recipients.Therefore,this study conducted a Meta-analysis on the relationship between perioperative infusion of dexmedetomidine and postoperative renal function recovery in kidney transplant recipients.Methods:The author searched clinical studies on the impact of perioperative infusion of DEX on postoperative renal function recovery in kidney transplant recipients from databases such as CNKI,Wanfang,Pubmed,Embase,Cochrane,Web of Science.The primary outcomes were delayed graft function(DGF),acute renal transplant rejection(ARTR)infection.Results:Seven studies were included in this Meta-analysis(including 6 randomized controlled trials and 1 retrospective study)with 1223 patients.Compared with the control group,the experimental group showed significant improvements in delayed graft function[OR=0.71,95%CI(0.52,0.97)],infection[OR=0.51,95%CI(0.33,0.78)],postoperative day 2 creatinine[MD=-0.21,95%CI(-0.37,-0.06)]and length of hospital stay[MD=-0.87,95%CI(-1.61,-0.13)].Conclusion:Perioperative infusion of dexmedetomidine may help reduce ischemia-reperfusion injury in kidney transplant patients.