己酮可可碱对炎症标志物和血压的影响：随机对照试验的系统评价和荟萃分析
Effects of pentoxifylline on inflammatory markers and blood pressure: a systematic review and meta-analysis of randomized controlled trials.
作者信息
Brie Daniel, Sahebkar Amirhossein, Penson Peter E, Dinca Madalina, Ursoniu Sorin, Serban Maria-Corina, Zanchetti Alberto, Howard George, Ahmed Ali, Aronow Wilbert S, Muntner Paul, Lip Gregory Y H, Wong Nathan D, Rysz Jacek, Banach Maciej
机构信息
aInstitute for Cardiovascular Medicine Timisoara, Cardiology Department, University of Medicine and Pharmacy 'Victor Babes', Timisoara, Romania bBiotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran cMetabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia dSchool of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK eIndependent Pharmacist Researcher, Leuven, Belgium fDepartment of Functional Sciences, Discipline of Public Health, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania gDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA hDepartment of Functional Sciences, Discipline of Pathophysiology, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania iIstituto Auxologico Italiano, University of Milan, Milan, Italy jDepartment of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA kVeterans Affairs Medical Center, Washington, District of Columbia lDepartment of Medicine, New York Medical College, Valhalla, New York, USA mUniversity of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK nDivision of Cardiology, Heart Disease Prevention Program, University of California, Irvine, California, USA oChair of Nephrology and Hypertension pDepartment of Hypertension, Chair of Nephrology and Hypertension, Medical University of Łódź, Łódź, Poland.
出版信息
J Hypertens. 2016 Dec;34(12):2318-2329. doi: 10.1097/HJH.0000000000001086.
INTRODUCTION
Pentoxifylline is a xanthine derivative with potential cardiovascular benefits.
AIM
To evaluate the impact of pentoxifylline on blood pressure (BP) and plasma TNF-α, C-reactive protein (CRP) and IL-6 through a systematic review and meta-analysis of randomized controlled trials.
METHODS
The protocol was registered (PROSPERO: CRD42016035988). The search included PUBMED, ProQuest, Scopus and EMBASE until 1 September 2015 to identify trials reporting BP or inflammatory markers during pentoxifylline therapy. Quantitative data synthesis was performed using a random-effects model, with weighted mean difference (WDF) and 95% confidence intervals (CIs) as summary statistics.
RESULTS
Fifteen studies (16 treatment arms) were found to be eligible for inclusion. Meta-analysis did not suggest any effect of pentoxifylline on either SBP or DBP. Pentoxifylline treatment was associated with a significant reduction in plasma concentrations of TNF-α (WDF: -1.03 pg/ml, 95% CI: -1.54, -0.51; P < 0.001, 11 treatment arms) and CRP (WDF: -1.39 mg/l, 95% CI: -2.68, -0.10; P = 0.034, five treatment arms). No alteration in plasma IL-6 concentration was observed. The impact of pentoxifylline on plasma TNF-α levels was found to be positively associated with treatment duration (slope: 0.031; 95% CI: 0.004, 0.057; P = 0.023) but independent of pentoxifylline dose (slope: -0.0003; 95% CI: -0.002, 0.001; P = 0.687).
CONCLUSION
Pentoxifylline did not alter BP or plasma IL-6 concentration, but significantly reduced circulating TNF-α and CRP concentrations.
引言
己酮可可碱是一种对心血管有益的黄嘌呤衍生物。
目的
通过对随机对照试验进行系统评价和荟萃分析，评估己酮可可碱对血压（BP）、血浆肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）和白细胞介素-6（IL-6）的影响。
方法
该方案已注册（国际前瞻性系统评价注册库：CRD42016035988）。检索截至2015年9月1日的PUBMED、ProQuest、Scopus和EMBASE，以确定报告己酮可可碱治疗期间血压或炎症标志物的试验。使用随机效应模型进行定量数据合成，加权平均差（WMD）和95%置信区间（CIs）作为汇总统计量。
结果
发现15项研究（16个治疗组）符合纳入标准。荟萃分析未提示己酮可可碱对收缩压或舒张压有任何影响。己酮可可碱治疗与血浆TNF-α浓度显著降低相关（WMD：-1.03 pg/ml，95%CI：-1.54，-0.51；P<0.001，11个治疗组）和CRP（WMD：-1.39 mg/l，95%CI：-2.68，-0.10；P=0.034，5个治疗组）。未观察到血浆IL-6浓度有变化。发现己酮可可碱对血浆TNF-α水平的影响与治疗持续时间呈正相关（斜率：0.031；95%CI：[0.004，0.057]；P=0.023），但与己酮可可碱剂量无关（斜率：-0.0003；95%CI：[-0.002，0.001]；P=0.687）。
结论
己酮可可碱未改变血压或血浆IL-6浓度，但显著降低了循环中的TNF-α和CRP浓度。
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