Department of Critical Care Medicine, West China School of Medicine, West China Hospital, Sichuan University, China.
Department of Respiratory and Critical Care Medicine, West China School of Medicine, West China Hospital, Sichuan University, China.
Am J Emerg Med. 2018 Aug;36(8):1486-1491. doi: 10.1016/j.ajem.2018.05.017. Epub 2018 May 21.
The effects of aspirin in preventing the occurrence of acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) among adult patients are controversial. We aimed to further determine the effectiveness of aspirin in reducing the rate of ARDS/ALI.
The Pubmed, Embase, Medline, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all controlled studies that research the role of aspirin in adult patients who have the risk of ARDS/ALI. The outcomes were the ARDS/ALI rate and the mortality. Cochrane systematic review software, Review Manager (RevMan), the R software for statistical computing version 3.2.0, and the metafor package were used to test the hypothesis by Mann-Whitney U test. The heterogeneity test and sensitivity analyses were conducted, and random-effects or fixed-effects model was applied to calculate odds ratio (OR) and mean difference (MD) for dichotomous and continuous data, respectively.
Six trials involving 6562 patients were pooled in our final study. No significant heterogeneity was found in outcome measures. Aspirin could reduce the rate of ARDS/ALI (OR 0.71, 95% confidence interval (CI) 0.58-0.86) but not the mortality (OR 0.87, 95% CI 0.71-1.07).
In patients with risk of ARDS/ALI, aspirin could provide protective effect on the rate of ARDS/ALI, but it could not reduce the mortality.
阿司匹林对预防成人急性呼吸窘迫综合征（ARDS）/急性肺损伤（ALI）的发生作用尚存争议。我们旨在进一步确定阿司匹林降低 ARDS/ALI 发生率的效果。
检索 Pubmed、Embase、Medline、ClinicalTrials.gov、Cochrane 中心对照试验注册库（CENTRAL）以及信息科学研究所（ISI）Web of Science 中的所有对照研究，这些研究均涉及阿司匹林对有 ARDS/ALI 风险的成年患者的作用。结局指标为 ARDS/ALI 发生率和死亡率。采用 Cochrane 系统评价软件、Review Manager（RevMan）、R 软件（用于统计计算的版本 3.2.0）和 metafor 包，采用 Mann-Whitney U 检验进行假设检验。进行了异质性检验和敏感性分析，并分别采用固定效应模型或随机效应模型计算二分类数据和连续数据的比值比（OR）和均数差（MD）。
最终纳入了 6 项共 6562 例患者的研究。结果未见明显异质性。阿司匹林可降低 ARDS/ALI 发生率（OR 0.71，95%置信区间（CI）0.58-0.86），但不降低死亡率（OR 0.87，95% CI 0.71-1.07）。
在有 ARDS/ALI 风险的患者中，阿司匹林对 ARDS/ALI 发生率有保护作用，但不能降低死亡率。
