肾缺血再灌注模型两性肾损伤差异的荟萃分析

摘要

目的 应用荟萃分析探求并评估啮齿类动物肾脏缺血再灌注模型中两性肾损伤差异.方法 检索PubMed与EMBASE数据库从2002年1月至2014年1月的相关文献,并阅读引入文献的参考文献以弥补缺漏.制定文献纳入及排除标准,并通过查阅文献制定效应指标的评价标准.采用Stata 12.0软件进行数据处理.结果 纳入14篇文献,共采用了289只动物.啮齿类动物在遭受肾脏缺血再灌注损伤后,雌性肾脏损伤程度在血肌酐[SMD=-5.95(-7.39,-4.51),P＜0.01]、尿素氮[SMD=-3.76(-5.60,-1.93),P＜0.01]均低于雄性.亚组分析显示,啮齿动物种类、肾脏缺血时间都会显著影响两性间肾脏损伤差异的大小;其中,缺血时间达45 min时,两性间差异达到最大.结论 啮齿动物在肾缺血再灌注后两性肾损伤程度存有差异,且缺血时间、动物种类会影响这种差异的程度.通过调整缺血时间可能会使两性损伤差异最大化.纳入的试验异质性较大且存在发表偏倚,尚需设计严谨实验.%Objective To evaluate the gender difference in renal ischemia/reperfusion injury in rodents conducting a meta-analysis.Methods Related literatures were searched from PubMed and Embase from 2002 to 2014.Including and excluding cretria were formulated.The articles were evaluated.Stata 12.0 was used to analyzed the data.Results 14 articles were included,with 289 animals.After renal ischemia/ reperfusion injury,Scr (SMD=-5.95 [-7.39,-4.51,P ＜ 0.01]),BUN (SMD=-3.76 [-5.60,-1.93],P ＜ 0.01),and pathological score (SMD=-3.32 [-4.65,-1.99]) were lower in the female than in the male rodents.Subgroup analysis indicated that species and ischemia time affected the difference; when ischemia time reached 45 min,the gender difference widened to its peak.Conclusions There is difference in renal injury between male and female rodents after renal ischemia/reperfusion.The difference could be affected by isckemia itme and animal species and could be reached to its peak adjusting ischemia time.Meanwhile,some clinical research can benefit from our findings.