Bai Lin, Litscher Gerhard, Li Xiaoning
Heilongjiang University of Chinese Medicine, Harbin 150040, China.
Swiss University of Traditional Chinese Medicine, SWISS TCM UNI, High-Tech Acupuncture and Digital Chinese Medicine, 5330 Bad Zurzach, Switzerland.
J Cardiovasc Dev Dis. 2024 Dec 21;11(12):409. doi: 10.3390/jcdd11120409.
Xanthine oxidase inhibitors (XOIs) may help prevent stroke. However, heterogeneity can be found in the conclusions of different studies. The relevant evidence was summarized in this systematic review and meta-analysis to further clarify the role of XOIs in the prevention and treatment of stroke, with a focus on evaluating the effects of XOIs in primary and secondary prevention of stroke, acute stroke treatment, and reduction of post-stroke complications.
Randomized controlled trials (RCTs) or cohort studies on the effect of XOIs in the prevention and treatment of stroke were searched in PubMed, EMBASE, and Cochrane Library from inception to 3 March 2024, along with hand searching. The analyses were carried out using Review Manager 5.4.
The analysis included 14 studies (115,579 patients). While XOIs did not significantly reduce the risk of stroke (RR: 0.89; 95% CI: 0.59-1.34), they improved post-stroke functional outcomes, with a reduction in the modified Rankin scale scores (mean difference: -0.6; 95% CI: -0.8 to -0.4), decreased intercellular adhesion molecule-1 levels (mean difference: -15.2 ng/mL; 95% CI: -22.3 to -8.1), improved augmentation index (AIx) by 4.2% (95% CI: 2.5-5.9%), reduced central blood pressure (mean reduction: 4.8 mmHg; 95% CI: 2.6-6.9), and delayed carotid intima-media thickness progression (mean difference: -0.05 mm/year; 95% CI: -0.08 to -0.02).
黄嘌呤氧化酶抑制剂（XOIs）可能有助于预防中风。然而，不同研究的结论存在异质性。本系统评价和荟萃分析总结了相关证据，以进一步阐明XOIs在中风防治中的作用，重点评估XOIs在中风一级和二级预防、急性中风治疗以及减少中风后并发症方面的效果。
从创刊至2024年3月3日，在PubMed、EMBASE和Cochrane图书馆中检索关于XOIs在中风防治中作用的随机对照试验（RCTs）或队列研究，并进行手工检索。使用Review Manager 5.4进行分析。
该分析纳入了14项研究（115,579例患者）。虽然XOIs并未显著降低中风风险（RR：0.89；95%CI：0.59 - 1.34），但它们改善了中风后的功能结局，改良Rankin量表评分降低（平均差值：-0.6；95%CI：-0.8至-0.4），细胞间黏附分子-1水平降低（平均差值：-15.2 ng/mL；95%CI：-22.3至-8.1），增强指数（AIx）改善了4.2%（95%CI：2.
