cyclooxygenase inhibitors

环氧合酶抑制剂
  • 文章类型: Journal Article
    阻抗聚集测定法是光透射聚集测定法的替代方法,其允许分析全血样品中的血小板功能。我们假设(1)阻抗聚集法会产生可重复的结果,(2)用阿司匹林抑制环氧合酶会减弱对胶原蛋白的聚集反应,并消除对花生四烯酸(AA)的聚集反应,和(3)血栓烷受体拮抗作用(terutroban)会减弱对AA的聚集反应。从11名参与者获得静脉血,间隔至少2周三次。一个样本随后进行7天的阿司匹林干预(81mg,每日一次;ASA),其他人没有干预(控制)。使用1μg/mL胶原蛋白([col])诱导聚集,5μg/mL胶原蛋白([col5]),和50mMAA通过阻抗聚集法来确定总聚集(AUC)分析测试中的可重复性,测试间重复性,干预(ASA或对照),和孵化(盐水或terutroban)。[col1]显示出较高的测试内(p≤0.03访问1和2)和测试间可重复性(p<0.01)。[col5]和AA显示了in-([col5]p<0.01访问1和2;AAp<0.001访问1和2),但没有测试间可重复性([col5]p=0.48;AAp=0.06)。ASA减弱了对[COL1]的AUC反应(p<0.01),[col5](p=0.03),和AA(p<0.01)。Terutroban减弱响应AA的AUC(p<0.01)。[col1]对于血小板功能的纵向研究显示出足够的可重复性。[col5]和AA可用于在单个时间点研究血小板功能和代谢的机制。
    Impedance aggregometry is an alternative to light transmission aggregometry that allows analysis of platelet function in whole blood samples. We hypothesized (1) impedance aggregometry would produce repeatable results, (2) inhibition of cyclooxygenase with aspirin would attenuate aggregation responses to collagen and abolish the aggregation response to arachidonic acid (AA), and (3) thromboxane receptor antagonism (terutroban) would attenuate the aggregation response to AA. Venous blood was obtained from 11 participants three times separated by at least 2 weeks. One sample followed 7-day-aspirin intervention (81 mg once daily; ASA), the others no intervention (control). Aggregation was induced using 1 μg/mL collagen ([col 1]), 5 μg/mL collagen ([col 5]), and 50 mM AA via impedance aggregometry to determine total aggregation (AUC) analyzed for intra-test repeatability, inter-test repeatability, intervention (ASA or control), and incubation (saline or terutroban). [col 1] showed high intra-test (p ≤ 0.03 visit 1 and 2) and inter-test repeatability (p < 0.01). [col 5] and AA showed intra- ([col 5] p < 0.01 visit 1 and 2; AA p < 0.001 visit 1 and 2) but not inter-test repeatability ([col 5] p = 0.48; AA p = 0.06). ASA attenuated AUC responses to [col 1] (p < 0.01), [col 5] (p = 0.03), and AA (p < 0.01). Terutroban attenuated AUC in response to AA (p < 0.01). [col 1] shows sufficient repeatability for longitudinal investigations of platelet function. [col 5] and AA may be used to investigate mechanisms of platelet function and metabolism at a single time point.
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  • 文章类型: Journal Article
    dMMR肿瘤,具有高肿瘤突变和新抗原负担,对免疫检查点封锁有高度反应。Wu等1表明,COX抑制剂与PD-1阻断联合可能是dMMR转移性结直肠癌的安全有效治疗选择。该研究强调了这种联合疗法在dMMR结直肠癌中实现深度和持久反应的潜力。
    dMMR tumors, which have high tumor mutational and neoantigen burdens, are highly responsive to immune checkpoint blockade. Wu et al.1 showed that combining COX inhibitors with PD-1 blockade could be a safe and effective treatment option for dMMR metastatic colorectal cancer. The study highlights the potential of this combination therapy in achieving deep and long-lasting responses in dMMR colorectal cancers.
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  • 文章类型: Journal Article
    在一项具有里程碑意义的研究中,oleocanthal(OLC),特级初榨橄榄油(EVOO)中的主要酚类物质,被发现具有类似于布洛芬的抗炎活性,涉及环氧合酶(COX)酶的抑制。EVOO是生物活性化合物的丰富来源,包括脂肪酸和酚类;然而,仅探索了一小部分与欧洲橄榄相关的化合物的生物学活性。这里,OliveNetTM文库(由600多种化合物组成)用于研究橄榄衍生化合物作为花生四烯酸途径的潜在调节剂.我们的第一个目的是进行酶测定,以评估某些酚类化合物和脂肪酸对COX同工型(COX-1和COX-2)和15-脂氧合酶(15-LOX)的抑制活性。发现橄榄化合物抑制COX亚型,对15-LOX的活性最小。随后的分子对接表明,橄榄化合物对COX亚型的活性位点具有很强的结合亲和力,和分子动力学(MD)模拟证实了结合的稳定性。此外,橄榄化合物被预测具有良好的药代动力学特性,包括准备穿过生物膜,如引导MD模拟和伞形采样所强调的。重要的是,基于膜片钳测定,将包括OLC的橄榄化合物鉴定为人醚-à-go-go相关基因(hERG)通道的非抑制剂。总的来说,这项研究扩展了我们对Olea-europaea衍生化合物的生物活性的理解,其中许多现在已知是,至少在某种程度上,对地中海饮食的有益健康影响负责。
    In a landmark study, oleocanthal (OLC), a major phenolic in extra virgin olive oil (EVOO), was found to possess anti-inflammatory activity similar to ibuprofen, involving inhibition of cyclooxygenase (COX) enzymes. EVOO is a rich source of bioactive compounds including fatty acids and phenolics; however, the biological activities of only a small subset of compounds associated with Olea europaea have been explored. Here, the OliveNetTM library (consisting of over 600 compounds) was utilized to investigate olive-derived compounds as potential modulators of the arachidonic acid pathway. Our first aim was to perform enzymatic assays to evaluate the inhibitory activity of a selection of phenolic compounds and fatty acids against COX isoforms (COX-1 and COX-2) and 15-lipoxygenase (15-LOX). Olive compounds were found to inhibit COX isoforms, with minimal activity against 15-LOX. Subsequent molecular docking indicated that the olive compounds possess strong binding affinities for the active site of COX isoforms, and molecular dynamics (MD) simulations confirmed the stability of binding. Moreover, olive compounds were predicted to have favorable pharmacokinetic properties, including a readiness to cross biological membranes as highlighted by steered MD simulations and umbrella sampling. Importantly, olive compounds including OLC were identified as non-inhibitors of the human ether-à-go-go-related gene (hERG) channel based on patch clamp assays. Overall, this study extends our understanding of the bioactivity of Olea-europaea-derived compounds, many of which are now known to be, at least in part, accountable for the beneficial health effects of the Mediterranean diet.
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  • 文章类型: Journal Article
    这项研究使用酶Alcalase和中生鱼类的自溶产生了生物活性水解产物,包括Maurolicusmuelleri和Benthosemalaciale.使用体外生物测定法研究了生成的水解产物的生物活性,和生物活性肽使用质谱鉴定活性水解产物与环氧合酶,二肽基肽酶IV和抗氧化活性。使用包括PeptideRanker在内的程序,采用计算机模拟分析对鉴定的肽序列进行总体生物活性排名。PrepAIP,Umami-MRNN和AntiDMPpred。预测七种肽具有抗炎作用,使用计算机策略的抗2型糖尿病或Umami潜力是化学合成的,并使用COX-1和COX-2酶的体外生物测定法证实了它们的抗炎活性。肽QCPLHRPWAL抑制COX-1和COX-282.90%(+/-0.54)和53.84%,分别,并且具有大于10的选择性指数。该肽作为新型抗炎/疼痛缓解肽需要进一步研究。鉴定了具有DPP-IV抑制和Umami风味的其他肽。这些提供了用作功能性食品或局部药剂以预防疼痛和炎症的潜力。
    This study generated bioactive hydrolysates using the enzyme Alcalase and autolysis from mesopelagic fish, including Maurolicus muelleri and Benthosema glaciale. Generated hydrolysates were investigated for their bioactivities using in vitro bioassays, and bioactive peptides were identified using mass spectrometry in active hydrolysates with cyclooxygenase, dipeptidyl peptidase IV and antioxidant activities. In silico analysis was employed to rank identified peptide sequences in terms of overall bioactivity using programmes including Peptide Ranker, PrepAIP, Umami-MRNN and AntiDMPpred. Seven peptides predicted to have anti-inflammatory, anti-type 2 diabetes or Umami potential using in silico strategies were chemically synthesised, and their anti-inflammatory activities were confirmed using in vitro bioassays with COX-1 and COX-2 enzymes. The peptide QCPLHRPWAL inhibited COX-1 and COX-2 by 82.90% (+/-0.54) and 53.84%, respectively, and had a selectivity index greater than 10. This peptide warrants further research as a novel anti-inflammatory/pain relief peptide. Other peptides with DPP-IV inhibitory and Umami flavours were identified. These offer potential for use as functional foods or topical agents to prevent pain and inflammation.
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  • 文章类型: Journal Article

    新数据表明对乙酰氨基酚可能会对肺部健康产生不利影响。我们研究了对乙酰氨基酚与单独用于动脉导管未闭(PDA)的环氧合酶(COX)抑制剂相比是否与极度早产儿的死亡率或呼吸道发病率相关。
    这是一项回顾性队列研究,使用美国国家儿童健康与人类发育研究所新生儿研究网络的数据。婴儿出生在妊娠22至28周,或在2016年至2020年之间体重401至1000克,并接受对乙酰氨基酚,布洛芬,和/或吲哚美辛用于PDA关闭。主要结局为月经后36周龄死亡或2-3级支气管肺发育不良(BPD)。次要结果包括出院前死亡率和呼吸道疾病。根据基线和出生后早期因素调整风险比。针对以后的出生后协变量调整了其他探索性分析。
    在1921名婴儿中,627(32.6%)接受对乙酰氨基酚,1294(67.3%)仅接受COX抑制剂。在对乙酰氨基酚暴露的婴儿中,多药治疗(42.9%vs4.7%)和手术或导管PDA闭合(26.5%vs19.9%)更为常见。经后36周龄时的死亡或2-3级BPD在接受对乙酰氨基酚治疗的婴儿与仅接受COX抑制剂治疗的婴儿之间相似(57.1%vs58.3%;调整后相对风险[aRR]0.96,95%置信区间[CI]0.87-1.06)。对乙酰氨基酚在校正围产期和出生后早期因素时与出院前死亡率增加(13.3%vs10.0%)相关(ARR1.42,95%CI1.02-1.93),但不包括产后后期因素的探索性分析(aRR1.28,95%CI0.91-1.82).
    对乙酰氨基酚与单纯COX抑制剂治疗PDA与极早产儿死亡或BPD的复合结局无关。我们的结果支持进一步评估对乙酰氨基酚用于PDA是否增加死亡率。

    OBJECTIVE: Emerging data indicate that acetaminophen may adversely affect lung health. We examined whether acetaminophen compared with cyclooxygenase (COX) inhibitor alone for patent ductus arteriosus (PDA) is associated with mortality or respiratory morbidity in extremely preterm infants.
    METHODS: This is a retrospective cohort study using data from the National Institute of Child Health and Human Development Neonatal Research Network. Infants were born at 22 to 28 weeks\' gestation or weighing 401 to 1000 g between 2016 and 2020 and received acetaminophen, ibuprofen, and/or indomethacin for PDA closure. The primary outcome was death or grade 2 to 3 bronchopulmonary dysplasia (BPD) at 36 weeks\' postmenstrual age. Secondary outcomes included predischarge mortality and respiratory morbidities. Risk ratios were adjusted for baseline and early postnatal factors. Additional exploratory analyses were adjusted for later postnatal covariates.
    RESULTS: Of 1921 infants, 627 (32.6%) received acetaminophen and 1294 (67.3%) received COX inhibitor only. Multidrug therapy (42.9% vs 4.7%) and surgical or catheter PDA closure (26.5% vs 19.9%) were more common among acetaminophen-exposed infants. Death or grade 2 to 3 BPD at 36 weeks\' postmenstrual age was similar between infants treated with acetaminophen versus COX inhibitor only (57.1% vs 58.3%; adjusted relative risk [aRR] 0.96, 95% confidence interval [CI] 0.87-1.06). Acetaminophen was associated with increased risk of predischarge mortality (13.3% vs 10.0%) when adjusting for perinatal and early postnatal factors (aRR 1.42, 95% CI 1.02-1.93), but not in exploratory analyses that included later postnatal factors (aRR 1.28, 95% CI 0.91-1.82).
    CONCLUSIONS: Treatment with acetaminophen versus COX inhibitor alone for PDA was not associated with the composite outcome of death or BPD in extremely preterm infants. Our results support further evaluation of whether acetaminophen for PDA increases mortality.
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  • 文章类型: Journal Article
    通过将壳聚糖与2-(4-甲酰苯氧基)-N-苯乙酰胺和N-(4-溴苯基)-2-(4-甲酰苯氧基)乙酰胺缩合合成了两种壳聚糖席夫碱,分别表示为Cs-SBA和Cs-SBBr,分别。使用FTIR和1HNMR表征了所得壳聚糖衍生物的分子结构,并通过TGA研究了它们的热性能。用三磷酸钠(TPP)处理这些衍生物以产生Cs席夫碱纳米颗粒。通过FTIR测定了纳米粒子的理化性质,XRD,TEM,和zeta电位分析。对幽门螺杆菌的抗菌作用(H。pylori)进行了评估,结果表明抗H.对于Cs-SBA和Cs-SBBr纳米颗粒(Cs-SBANP和Cs-SBBrNP),幽门螺杆菌活性的最小抑制浓度MIC值为15.62±0.05和3.9±0.03μg/mL,分别。更好的生物活性纳米粒子,Cs-SBBrNPs,测试了它们的环氧合酶(COX-1和COX-2)抑制潜力。Cs-SBBrNP对COX-2的COX酶抑制活性(IC504.5±0.165μg/mL)高于常规吲哚美辛(IC500.08±0.003μg/mL),和塞来昔布(IC50为0.79±0.029μg/mL)。此外,Cs-SBBrNP的细胞毒性试验显示对Vero细胞(CCL-81)的细胞毒性作用,IC50=17.95±0.12μg/mL,被认为是安全的化合物。因此,Cs-SBBrNP可能成为治疗幽门螺杆菌和预防胃癌的替代药物。
    Two chitosan Schiff bases were synthesized by condensation of chitosan with 2-(4-formylphenoxy)-N-phenylacetamide and N-(4-bromophenyl)-2-(4-formylphenoxy) acetamide denoted as Cs-SBA and Cs-SBBr, respectively. The molecular structures of the resulting chitosan derivatives were characterized using FTIR and 1HNMR and their thermal properties were investigated by TGA. These derivatives were treated with sodium tripolyphosphate (TPP) to produce Cs Schiff base nanoparticles. The nanoparticles physicochemical properties were determined by FTIR, XRD, TEM, and zeta potential analysis. The antimicrobial action against Helicobacter pylori (H. pylori) was evaluated and the results indicated that the anti-H. pylori activity had minimal inhibitory concentration MIC values of 15.62 ± 0.05 and 3.9 ± 0.03 μg/mL for Cs-SBA and Cs-SBBr nanoparticles (Cs-SBA NPs and Cs-SBBr NPs), respectively. The better biologically active nanoparticles, Cs-SBBr NPs, were tested for their cyclooxygenases (COX-1 and COX-2) inhibitory potential. Cs-SBBr NPs demonstrated COX enzyme inhibition activity against COX-2 (IC50 4.5 ± 0.165 μg/mL) higher than the conventional Indomethacin (IC50 0.08 ± 0.003 μg/mL), and Celecoxib (IC50 0.79 ± 0.029 μg/mL). Additionally, the cytotoxicity test of Cs-SBBr NPs showed cytotoxic effect on Vero cells (CCL-81) with IC50 = 17.95 ± 0.12 μg/mL which is regarded as a safe compound. Therefore, Cs-SBBr NPs may become an alternative to cure H. pylori and prevent gastric cancer.
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  • 文章类型: Journal Article
    旨在发现有效和安全的非甾体抗炎药,一套新的1,2,4-三唑四氢呋喃异喹啉杂化物9a-g,合成11a-g和12a-g并评价为COX-1和COX-2的抑制剂。为了克服高选择性COX-2和非选择性COX-2抑制剂的不良反应,本研究的化合物的设计目的是获得中等选择性的COX-2抑制剂。在本研究中,化合物9e,9g和11f是对COX-2最有效的衍生物,IC50值为0.87、1.27和0.58µM,分别优于或与标准药物塞来昔布(IC50=0.82µM)相当,但选择性指数较低,如我们的目标设计所要求的。体内抗炎抑制试验结果表明,化合物9e,9g和11f在所有时间间隔显示出比塞来考昔更高的显著抗炎活性。此外,这些化合物显著降低了炎症介质PGE-2、TNF-α和IL-6的产生。化合物9e,与消炎痛相比,9g和11f具有安全的胃轮廓,此外,化合物11f(致溃疡指数=1.33)的溃疡性比安全的塞来昔布(致溃疡指数=3)低。此外,组织病理学研究显示,用化合物11f口服大鼠后,爪皮肤和胃粘膜的结构均正常。此外,在COX-1和COX-2上进行分子对接研究以研究化合物9e的结合模式,9g和11f两种同工酶。
    Aiming to discover effective and safe non-steroidal anti-inflammatory agents, a new set of 1,2,4-triazole tetrahydroisoquinoline hybrids 9a-g, 11a-g and 12a-g was synthesized and evaluated as inhibitors of COX-1 and COX-2. In order to overcome the adverse effects of highly selective COX-2 and non-selective COX-2 inhibitors, the compounds of this study were designed with the goal of obtaining moderately selective COX-2 inhibitors. In this study compounds 9e, 9g and 11f are the most effective derivatives against COX-2 with IC50 values 0.87, 1.27 and 0.58 µM, respectively which are better than or comparable to the standard drug celecoxib (IC50 = 0.82 µM) but with lower selectivity indices as required by our goal design. The results of the in vivo anti-inflammatory inhibition test revealed that compounds 9e, 9g and 11f displayed a higher significant anti-inflammatory activity than celecoxib at all-time intervals. In addition, these compounds significantly decreased the production of inflammatory mediators PGE-2, TNF-ɑ and IL-6. Compounds 9e, 9g and 11f had a safe gastric profile compared to indomethacin, also compound 11f (ulcerogenic index = 1.33) was less ulcerous than the safe celecoxib (ulcerogenic index = 3). Moreover, histopathological investigations revealed a normal architecture of both paw skin and gastric mucosa after oral treatment of rats with compound 11f. Furthermore, molecular docking studies were performed on COX-1 and COX-2 to study the binding pattern of compounds 9e, 9g and 11f on both isoenzymes.
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  • 文章类型: Journal Article
    免疫医治是肿瘤医治的新前沿。治疗性放射是已知的免疫应答诱导物,并且可以受到免疫抑制介质的限制,所述免疫抑制介质包括在侵袭性三阴性乳腺癌(TNBC)中高度表达的环氧合酶-2(COX2)。TNBC肿瘤的临床队列显示,在表达高COX2的肿瘤中,放射治疗效果较差。在这里,我们表明,辐射联合辅助NSAID(吲哚美辛)治疗提供了一个强大的组合,以减少原发性肿瘤生长和侵袭性4T1TNBC肿瘤的肺转移,这在某种程度上是通过增加抗肿瘤免疫反应而发生的。在用吲哚美辛治疗的4T1肿瘤中观察到空间免疫学变化,包括淋巴样浸润增加到肿瘤上皮中,cGAS/STING1和I型IFN基因表达局部增加。因此,在这些具有免疫挑战性的肿瘤中,辐射和辅助NSAID治疗将“免疫沙漠表型”转向抗肿瘤M1/TH1免疫介质。重要的是,辐射-吲哚美辛联合治疗改善了原发性病变的局部控制,减少转移负担,与单独放射治疗相比,中位生存期增加。这些结果表明,临床上可用的NSAID可以通过增加的抗肿瘤免疫应答和增加的cGAS/STING1和I型IFN的局部产生来改善放射治疗功效。
    Immune therapy is the new frontier of cancer treatment. Therapeutic radiation is a known inducer of immune response and can be limited by immunosuppressive mediators including cyclooxygenase-2 (COX2) that is highly expressed in aggressive triple negative breast cancer (TNBC). A clinical cohort of TNBC tumors revealed poor radiation therapeutic efficacy in tumors expressing high COX2. Herein, we show that radiation combined with adjuvant NSAID (indomethacin) treatment provides a powerful combination to reduce both primary tumor growth and lung metastasis in aggressive 4T1 TNBC tumors, which occurs in part through increased antitumor immune response. Spatial immunological changes including augmented lymphoid infiltration into the tumor epithelium and locally increased cGAS/STING1 and type I IFN gene expression were observed in radiation-indomethacin-treated 4T1 tumors. Thus, radiation and adjuvant NSAID treatment shifts \"immune desert phenotypes\" toward antitumor M1/TH1 immune mediators in these immunologically challenging tumors. Importantly, radiation-indomethacin combination treatment improved local control of the primary lesion, reduced metastatic burden, and increased median survival when compared with radiation treatment alone. These results show that clinically available NSAIDs can improve radiation therapeutic efficacy through increased antitumor immune response and augmented local generation of cGAS/STING1 and type I IFNs.
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  • 文章类型: Journal Article
    从一品红根中分离出的镰刀菌培养液的乙酸乙酯提取物的代谢物探索提供了五种化合物;4-羟基苯甲醛(1),4-羟基苯甲酸(2),酪醇(3),壬二酸(4),苹果酸(5),和镰刀酸(6)。通过体外环氧合酶和酪氨酸酶抑制试验,评估了真菌提取物及其代谢物的抗炎和抗色素沉着潜能,分别。壬二酸(4)表现出强大和选择性的COX-2抑制作用,其次是镰刀酸(6),IC50值(2.21±0.06和4.81±0.14μM,分别)。同样,与曲酸相比,壬二酸(4)具有最令人印象深刻的酪氨酸酶抑制作用,IC50值为8.75±0.18μM(IC50=9.27±0.19μM)。用COX-2对壬二酸和褐煤酸进行的独家计算研究与体外结果吻合良好。有趣的是,这是首次研究和报道化合物3-6抑制环氧合酶的潜力。最具侵袭性的皮肤癌之一是黑色素瘤,一项使用一组与黑色素瘤相关的酶的分子对接研究表明,pirin是壬二酸和镰刀酸的治疗靶标,这是它们抗黑色素瘤活性的合理机制。
    Metabolites exploration of the ethyl acetate extract of Fusarium solani culture broth that was isolated from Euphorbia tirucalli root afforded five compounds; 4-hydroxybenzaldehyde (1), 4-hydroxybenzoic acid (2), tyrosol (3), azelaic acid (4), malic acid (5), and fusaric acid (6). Fungal extract as well as its metabolites were evaluated for their anti-inflammatory and anti-hyperpigmentation potential via in vitro cyclooxygenases and tyrosinase inhibition assays, respectively. Azelaic acid (4) exhibited powerful and selective COX-2 inhibition followed by fusaric acid (6) with IC50 values (2.21 ± 0.06 and 4.81 ± 0.14 μM, respectively). As well, azelaic acid (4) had the most impressive tyrosinase inhibitory effect with IC50 value of 8.75 ± 0.18 μM compared to kojic acid (IC50 = 9.27 ± 0.19 μM). Exclusive computational studies of azelaic acid and fusaric acid with COX-2 were in good accord with the in vitro results. Interestingly, this is the first time to investigate and report the potential of compounds 3-6 to inhibit cyclooxygenase enzymes. One of the most invasive forms of skin cancer is melanoma, a molecular docking study using a set of enzymes related to melanoma suggested pirin to be therapeutic target for azelaic acid and fusaric acid as a plausible mechanism for their anti-melanoma activity.
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    背景:非甾体抗炎药(NSAID)的使用已被研究为胰十二指肠切除术(PD)后术后胰瘘(POPF)的可改变的危险因素。本研究包括系统评价和荟萃分析,探讨围手术期使用NSAID对PD后POPF发生率的影响。
    方法:进行了符合PRISMA2020的系统评价。集合平均差(MD),赔率比(OR),计算风险比(RR)和95%置信区间(CI)。
    结果:纳入了2015-2021年发表的七项研究,报告2,851个PD(1,372个接收NSAIDs,1,479个未收到NSAIDs)。失血没有差异(MD-99.40mL;CI-201.71-2.91;P=0.06),总发病率(OR1.05;CI0.68-1.61;P=0.83),出血(OR2.35;CI0.48-11.59;P=0.29),胃排空延迟(OR0.98;0.60-1.60;P-0.93),胆漏(OR0.68;CI0.12-3.89;P=0.66),手术部位感染(OR1.02;CI0.33-3.22;P=0.97),脓肿(OR0.99;CI0.51-1.91;P=0.97),临床相关POPF(OR1.18;CI0.84-1.64;P=0.33),再入院(OR0.94;CI0.61-1.46;P=0.78),或再次手术(OR0.82;CI0.33-2.06;P=0.68)。使用NSAID与住院时间较短相关(MD-1.05天;CI-1.39-0.71;P<0.00001)。
    结论:在接受PD的患者围手术期使用NSAIDs与POPF发生率的增加无关。
    BACKGROUND: Nonsteroidal anti-inflammatory drug (NSAID) use has been investigated as a modifiable risk factor for postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). This study comprises a systematic review and meta-analysis examining the impact of perioperative NSAID use on rates of POPF after PD.
    METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-compliant systematic review was performed. Pooled mean differences (MD), odds ratios (OR), and risk ratios with 95% CIs were calculated.
    RESULTS: Seven studies published from 2015 to 2021 were included, reporting 2851 PDs (1372 receiving NSAIDs and 1479 not receiving NSAIDs). There were no differences regarding blood loss (MD -99.40 mL; 95% CI, -201.71 to 2.91; P = .06), overall morbidity (OR 1.05; 95% CI, 0.68-1.61; P = .83), hemorrhage (OR 2.35; 95% CI, 0.48-11.59; P = .29), delayed gastric emptying (OR 0.98; 95% CI, 0.60-1.60; P = .93), bile leak (OR 0.68; 95% CI, 0.12-3.89; P = .66), surgical site infection (OR 1.02; 95% CI, 0.33-3.22; P = .97), abscess (OR 0.99; 95% CI, 0.51-1.91; P = .97), clinically relevant POPF (OR 1.18; 95% CI, 0.84-1.64; P = .33), readmission (OR 0.94; 95% CI, 0.61-1.46; P = .78), or reoperation (OR 0.82; 95% CI, 0.33-2.06; P = .68). NSAID use was associated with a shorter hospital stay (MD -1.05 days; 95% CI, -1.39 to 0.71; P < .00001).
    CONCLUSIONS: The use of NSAIDs in the perioperative period for patients undergoing PD was not associated with increased rates of POPF.
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