Department of Anesthesiology, The third Affiliated hospital of Sun Yat-sen University, Guangzhou, 510630, China.
Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
BMC Anesthesiol. 2023 May 31;23(1):189. doi: 10.1186/s12871-023-02117-w.
Decreased bioavailability of nitric oxide (NO) under hypoxic conditions can lead to endothelial dysfunction. NO supplementation may protect endothelial function in ischemia-reperfusion (IR) injury. Therefore, a meta-analysis of randomized controlled trials (RCTs) was performed to verify the protective effect of NO donors on endothelium in IR injury.
Medline, Embase, Cochrane Library, and Web of Science databases were searched from inception to April 1, 2023. The specific inclusion criteria were as follows: (1) RCTs; (2) trials comparing NO donors with placebo control groups; and (3) trials reporting the effects of these interventions on vascular endothelial functional outcomes in IR injury. Random-effects models were used to assess pooled effect sizes, which were expressed as standardized mean differences (SMD).
Seven studies satisfied the inclusion criteria and consisted of a total of 149 participants. NO donors were protective of endothelial function in IR injury (SMD: - 1.60; 95% confidence interval [CI]: - 2.33, - 0.88, P < 0.0001; heterogeneity [I = 66%, P = 0.001]). Results of the subgroup analysis showed the following: absence of protective effect of NO donor use following ischemia on endothelial function in IR injury - 1.78 (95% CI: - 2.50, - 1.07) and loss of protective effect on endothelial function after prolonged NO donor use - 0.89 (95% CI: - 2.06, 0.28).
The short-period use of NO donors before the onset of ischemia can protect endothelial function in IR injury.
在缺氧条件下，一氧化氮（NO）的生物利用度降低会导致内皮功能障碍。NO 补充剂可能会保护缺血再灌注（IR）损伤中的内皮功能。因此，进行了一项荟萃分析，以验证 NO 供体对 IR 损伤中内皮的保护作用。
从成立到 2023 年 4 月 1 日，检索了 Medline、Embase、Cochrane 图书馆和 Web of Science 数据库。具体纳入标准如下：（1）RCT；（2）比较 NO 供体与安慰剂对照组的试验；（3）报告这些干预措施对 IR 损伤中血管内皮功能结局影响的试验。使用随机效应模型评估汇总效应大小，以标准化均数差（SMD）表示。
有 7 项研究符合纳入标准，共纳入 149 名参与者。NO 供体对 IR 损伤中的内皮功能具有保护作用（SMD：-1.60；95%置信区间 [CI]：-2.33，-0.88，P<0.0001；异质性 [I=66%，P=0.001]）。亚组分析结果显示：缺血后使用 NO 供体对 IR 损伤内皮功能没有保护作用-1.78（95% CI：-2.50，-1.07），长时间使用 NO 供体后对内皮功能的保护作用丧失-0.89（95% CI：-2.06，0.28）。
在缺血发作前短期使用 NO 供体可以保护 IR 损伤中的内皮功能。
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