喷托非韦林在新生儿缺氧缺血性脑病中的作用:动物研究的系统回顾。

IF 2.7 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Florence Wong, Chandra Rath, Bhanu B Gowda, Sanjay Patole
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引用次数: 0

摘要

我们系统地回顾了评估喷托非利兰对新生儿缺氧缺血性脑病(HIE)影响的动物实验证据。2023 年 12 月,我们在 PubMed、EMBASE、EMCARE、MEDLINE、Cochrane Library 和 Google Scholar 数据库中检索了随机对照试验和准随机对照试验 (RCT),以确定戊唑醇在 HIE 动物模型中的效果。纳入研究的质量通过SYRCLE偏倚风险(ROB)工具进行评估。证据的确定性通过 GRADE 方法进行评估。所有七项纳入研究(n = 248)均涉及大鼠 HIE 模型,在该模型中,腹腔注射喷托非利兰(25-150 毫克/千克)。大多数研究的投资回报率不明确。所有研究都显示,喷托非韦林对 HIE 引起的器官损伤具有保护作用。与对照组相比,25至75毫克/千克戊氧地胆碱剂量组的死亡率相当,但150毫克/千克剂量组的死亡率较高。三项研究报告了 HIE 受影响器官的宏观变化。脑梗塞(40 和 75 毫克/千克)、海马萎缩和可见肠道损伤(60 毫克/千克)明显减少。剂量为 60 毫克/千克时,Caspase 3 免疫活性细胞和坏死细胞的数量明显减少,而剂量为 100 毫克/千克时,则会产生有害影响。另有三项研究报告称,IL-6 和 TNF-α 等促炎标志物的水平明显降低。来自大鼠模型的现有证据(不确定性较低)表明,戊氧地胆碱有可能改善 HIE 后的死亡率并减轻器官损伤。要证实我们的研究结果,还需要进行充分的、设计良好的人体 RCT 研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of pentoxifylline in neonatal hypoxic ischaemic encephalopathy: a systematic review of animal studies.

We systematically reviewed the evidence from animal studies assessing the effects of pentoxifylline on neonatal hypoxic-ischemic encephalopathy (HIE). The PubMed, EMBASE, EMCARE, MEDLINE, Cochrane Library, and Google Scholar databases were searched for randomized and quasi randomized controlled trials (RCTs) in December 2023 to determine the effects of pentoxifylline in animal models of HIE. The quality of the included studies was assessed via the SYRCLE risk of bias (ROB) tool. The certainty of evidence was assessed via the GRADE methodology. All seven included studies (n = 248) involved a rat HIE model in which pentoxifylline (25-150 mg/kg) was administered intraperitoneally. The majority had unclear ROB. All the studies reported a protective effect of pentoxifylline on HIE-induced organ injury. Mortality was comparable at pentoxifylline doses between 25 and 75 mg/kg but higher at 150 mg/kg than in the control group. Three studies reported macroscopic changes in HIE-affected organs. There was a significant reduction in cerebral infarction (40 and 75 mg/kg), hippocampal atrophy, and visible gut injury (60 mg/kg). A significantly lower number of Caspase 3 immunoreactive cells and necrotic cells were observed at the 60 mg/kg dose, whereas the 100 mg/kg dose had a deleterious effect. Three other studies reported significantly reduced levels of proinflammatory markers including IL-6 and TNF-alpha. Current evidence (with low uncertainty) from a rat model suggests that pentoxifylline has the potential to improve mortality and attenuate organ injury following HIE. Adequately powered, well-designed human RCTs are needed to confirm our findings.

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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
32
审稿时长
8 weeks
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