PDF(Pubmed)
Abstract：
OBJECTIVE: Mild hypothermia in hepatic ischemia-reperfusion injury is increasingly being studied. This study aimed to conduct a systematic evaluation of the effectiveness of mild hypothermia in improving hepatic ischemia-reperfusion injury.
METHODS: We systematically searched CNKI, WanFang Data, PubMed, Embase, and Web of Science for original studies that used animal experiments to determine how mild hypothermia(32-34°C) pretreatment improves hepatic ischemia-reperfusion injury(in situ 70% liver IR model). The search period ranged from the inception of the databases to May 5, 2023. Two researchers independently filtered the literature, extracted the data, and assessed the risk of bias incorporated into the study. The meta-analysis was performed using RevMan 5.4.1 and Stata 15 software.
RESULTS: Eight randomized controlled trials (RCTs) involving a total of 117 rats/mice were included. The results showed that the ALT levels in the mild hypothermia pretreatment group were significantly lower than those in the normothermic control group [Standardized Mean Difference (SMD) = -5.94, 95% CI(-8.09, -3.78), P<0.001], and AST levels in the mild hypothermia pretreatment group were significantly lower than those in the normothermic control group [SMD = -4.45, 95% CI (-6.10, -2.78), P<0.001]. The hepatocyte apoptosis rate in the mild hypothermia pretreatment group was significantly lower than that in the normothermic control group [SMD = -6.86, 95% CI (-10.38, -3.33), P<0.001]. Hepatocyte pathology score in the mild hypothermia pretreatment group was significantly lower than that in the normothermic control group [SMD = -4.36, 95% CI (-5.78, -2.95), P<0.001]. There was no significant difference in MPO levels between the mild hypothermia preconditioning group and the normothermic control group [SMD = -4.83, 95% CI (-11.26, 1.60), P = 0.14]. SOD levels in the mild hypothermia preconditioning group were significantly higher than those in the normothermic control group [SMD = 3.21, 95% CI (1.27, 5.14), P = 0.001]. MDA levels in the mild hypothermia pretreatment group were significantly lower than those in the normothermic control group [SMD = -4.06, 95% CI (-7.06, -1.07) P = 0.008].
CONCLUSIONS: Mild hypothermia can attenuate hepatic ischemia-reperfusion injury, effectively reduce oxidative stress and inflammatory response, prevent hepatocyte apoptosis, and protect liver function.
METHODS: We systematically searched CNKI, WanFang Data, PubMed, Embase, and Web of Science for original studies that used animal experiments to determine how mild hypothermia(32-34°C) pretreatment improves hepatic ischemia-reperfusion injury(in situ 70% liver IR model). The search period ranged from the inception of the databases to May 5, 2023. Two researchers independently filtered the literature, extracted the data, and assessed the risk of bias incorporated into the study. The meta-analysis was performed using RevMan 5.4.1 and Stata 15 software.
RESULTS: Eight randomized controlled trials (RCTs) involving a total of 117 rats/mice were included. The results showed that the ALT levels in the mild hypothermia pretreatment group were significantly lower than those in the normothermic control group [Standardized Mean Difference (SMD) = -5.94, 95% CI(-8.09, -3.78), P<0.001], and AST levels in the mild hypothermia pretreatment group were significantly lower than those in the normothermic control group [SMD = -4.45, 95% CI (-6.10, -2.78), P<0.001]. The hepatocyte apoptosis rate in the mild hypothermia pretreatment group was significantly lower than that in the normothermic control group [SMD = -6.86, 95% CI (-10.38, -3.33), P<0.001]. Hepatocyte pathology score in the mild hypothermia pretreatment group was significantly lower than that in the normothermic control group [SMD = -4.36, 95% CI (-5.78, -2.95), P<0.001]. There was no significant difference in MPO levels between the mild hypothermia preconditioning group and the normothermic control group [SMD = -4.83, 95% CI (-11.26, 1.60), P = 0.14]. SOD levels in the mild hypothermia preconditioning group were significantly higher than those in the normothermic control group [SMD = 3.21, 95% CI (1.27, 5.14), P = 0.001]. MDA levels in the mild hypothermia pretreatment group were significantly lower than those in the normothermic control group [SMD = -4.06, 95% CI (-7.06, -1.07) P = 0.008].
CONCLUSIONS: Mild hypothermia can attenuate hepatic ischemia-reperfusion injury, effectively reduce oxidative stress and inflammatory response, prevent hepatocyte apoptosis, and protect liver function.
摘要：
目的：亚低温在肝脏缺血再灌注损伤中的作用研究日益增多。本研究旨在系统评价亚低温改善肝脏缺血再灌注损伤的效果。
方法：我们系统地搜索了CNKI，万方数据,PubMed,Embase,和WebofScience的原始研究，使用动物实验来确定亚低温（32-34°C）预处理如何改善肝脏缺血再灌注损伤（原位70％肝脏IR模型）。搜索期从数据库开始到2023年5月5日。两名研究人员独立过滤了文献，提取数据，并评估纳入研究的偏倚风险。Meta分析采用RevMan5.4.1和Stata15软件进行。
结果：共涉及117只大鼠/小鼠的8项随机对照试验（RCT）。结果显示,亚低温预处理组ALT水平明显低于常温对照组[标准化平均差(SMD)=-5.94,95%CI(-8.09,-3.78),P<0.001],亚低温预处理组的AST水平明显低于常温对照组[SMD=-4.45，95％CI（-6.10，-2.78），P<0.001]。亚低温预处理组肝细胞凋亡率明显低于常温对照组[SMD=-6.86,95%CI(-10.38,-3.33),P<0.001]。亚低温预处理组肝细胞病理评分明显低于常温对照组[SMD=-4.36,95%CI(-5.78,-2.95),P<0.001]。亚低温预处理组与常温对照组MPO水平无显著差异[SMD=-4.83,95%CI(-11.26,1.60),P=0.14]。亚低温预处理组的SOD水平明显高于常温对照组[SMD=3.21,95%CI(1.27,5.14),P=0.001]。亚低温预处理组MDA水平显著低于常温对照组[SMD=-4.06,95%CI(-7.06,-1.07)P=0.008]。
结论：亚低温可以减轻肝脏缺血再灌注损伤，有效减少氧化应激和炎症反应，防止肝细胞凋亡，保护肝功能.
方法：我们系统地搜索了CNKI，万方数据,PubMed,Embase,和WebofScience的原始研究，使用动物实验来确定亚低温（32-34°C）预处理如何改善肝脏缺血再灌注损伤（原位70％肝脏IR模型）。搜索期从数据库开始到2023年5月5日。两名研究人员独立过滤了文献，提取数据，并评估纳入研究的偏倚风险。Meta分析采用RevMan5.4.1和Stata15软件进行。
结果：共涉及117只大鼠/小鼠的8项随机对照试验（RCT）。结果显示,亚低温预处理组ALT水平明显低于常温对照组[标准化平均差(SMD)=-5.94,95%CI(-8.09,-3.78),P<0.001],亚低温预处理组的AST水平明显低于常温对照组[SMD=-4.45，95％CI（-6.10，-2.78），P<0.001]。亚低温预处理组肝细胞凋亡率明显低于常温对照组[SMD=-6.86,95%CI(-10.38,-3.33),P<0.001]。亚低温预处理组肝细胞病理评分明显低于常温对照组[SMD=-4.36,95%CI(-5.78,-2.95),P<0.001]。亚低温预处理组与常温对照组MPO水平无显著差异[SMD=-4.83,95%CI(-11.26,1.60),P=0.14]。亚低温预处理组的SOD水平明显高于常温对照组[SMD=3.21,95%CI(1.27,5.14),P=0.001]。亚低温预处理组MDA水平显著低于常温对照组[SMD=-4.06,95%CI(-7.06,-1.07)P=0.008]。
结论：亚低温可以减轻肝脏缺血再灌注损伤，有效减少氧化应激和炎症反应，防止肝细胞凋亡，保护肝功能.
