Yang Yang, Feng Yun, Zhou Xiao-Guang, Pan Jing-Jing, Zhou Xiao-Yu
Department of Neonates, Nanjing Children's Hospital of Nanjing Medical University, Nanjing 210008, P. R. China.
Department of Pediatrics, Jiangsu Provincial Hospital of Nanjing Medical University, Nanjing 210029, P. R. China.
J Res Med Sci. 2016 Jun 14;21:41. doi: 10.4103/1735-1995.183990. eCollection 2016.
In the past several years, randomized controlled trials (RCTs) have indicated that inhaled nitric oxide (iNO) can potentially lower for both the incidence of bronchopulmonary dysplasia (BPD) and mortality in affected infants. Other research has, however, disagreed with these findings.
We performed an updated meta analysis of all relevant RCTs to assess the benefits of iNO in preterm infants by searching PubMed, EMBASE, Cochrane databases, Wanfang, VIP, and CNKI databases for English and Chinese references.
Ultimately, 22 RCTs were incorporated. (1) Risk of BPD was significantly lower in preterm infants supplemented with iNO (relative risk [RR] = 0.88; = 0.0007). There are no differences concerning pulmonary hemorrhage (PH) (RR = 0.94; = 0.72). (2) Incidences of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and severe intracranial hemorrhage (ICH) were compared. No significant difference was discovered concerning these risks (RR = 1.21, = 0.08; RR = 1.01, = 0.89; and RR = 0.99, = 0.86). (3) In addition, no significant differences were found between experimental and control groups with respect to morality. (RR = 1.00, = 0.98).
Our meta analysis has shown a beneficial effect in BPD and morality. In addition, our meta analysis suggests that iNO therapy does not increase the risk of common complications, such as NEC and ROP, and that it may also have no adverse effect on bleeding tendency diseases (severe ICH and PH).
在过去几年中，随机对照试验（RCT）表明，吸入一氧化氮（iNO）可能降低患支气管肺发育不良（BPD）的婴儿的发病率和死亡率。然而，其他研究对此结果存在分歧。
我们通过检索PubMed、EMBASE、Cochrane数据库、万方、维普和知网数据库中的英文和中文参考文献，对所有相关RCT进行了更新的荟萃分析，以评估iNO对早产儿的益处。
最终纳入了22项RCT。（1）补充iNO的早产儿患BPD的风险显著降低（相对风险[RR]=0.88；P=0.0007）。在肺出血（PH）方面无差异（RR=0.94；P=0.72）。（2）比较了坏死性小肠结肠炎（NEC）、早产儿视网膜病变（ROP）和重度颅内出血（ICH）的发生率。在这些风险方面未发现显著差异（RR=1.21，P=0.08；RR=1.01，P=0.89；RR=0.99，P=0.86）。（3）此外，实验组和对照组在死亡率方面无显著差异（RR=1.00，P=0.98）。
我们的荟萃分析显示iNO对BPD和死亡率有有益影响。此外，我们的荟萃分析表明，iNO治疗不会增加常见并发症（如NEC和ROP）的风险，并且对出血性疾病（重度ICH和PH）可能也无不良影响。
