急性心肌梗死后自体脊髓干细胞注射治疗的Meta分析  

Meta-analysis of the efficacy of autologous bone marrow stem cells in treatment of acute myocardial infarction

作　　者：吴青青[1] 方译[1] 徐蔓[1] 杨政[1] 卞洲艳[1] 唐其柱[1] 

机构地区：[1]武汉大学第一临床学院心内科,硕士研究生在读430060

出　　处：《中华临床医师杂志（电子版）》2012年第24期8167-8172,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：武汉大学自主科研项目(2012302020211)

摘　　要：目的本系统综述旨在较为全面地评估应用骨髓干细胞治疗心肌梗死后患者左心室收缩功能改善情况,反映骨髓干细胞治疗心肌梗死的现状。方法以"急性心肌梗死"、"骨髓干细胞"为关键词计算机检索Cochrane图书馆(2011年第3期)、ISI Web of Knowledge(建库～2012年)、MEDLINE(建库～2012年)、EMbase(建库～2012年)、PubMed(建库～2012年)。以中文关键词"急性心肌梗死"、限定词"骨髓干细胞"计算机检索万方数据库(建库～2012年)、中国知网(建库～2012年)、维普资讯(建库～2012年),对符合质量标准的随机对照试验(RCT)进行Meta分析。统计学分析采用RevMan5.0.25软件。结果共纳入11个RCT包括1029例患者。Meta分析显示,骨髓干细胞治疗与安慰剂治疗组相比其左心室射血分数(LVEF)提高[2.08,95%CI(1.04,3.13),P<0.0001];左心室收缩末内径(LVESV)减小[-5.16,95%CI(-7.64,-2.67),P<0.0001];左心室舒张末期内径(LVEDV)无改善[-1.65,95%CI(-4.92,1.61),P=0.32]。结论目前证据显示骨髓干细胞治疗急性心肌梗死能提高患者左心室射血功能和左心室收缩功能,但是不能改善患者左心室舒张功能。Objective To evaluate the efficacy of bone marrow stem cells in treatment of acute myocardial infarction.Methods PubMed MEDLINE,Cochrane and China National Knowledge Infrastructure(CNKI)databases were searched for the literatures on the clinical trials of bone marrow stem cells in treatment of acute myocardial infarction using key words of 'acute myocardial infarction','bone marrow stem cells'.A manual search of those trials was simultaneously performed.A Meta-analysis was conducted on the outcomes of the included trials with the assistance of RevMan 5.0.25 software.Results Totally 11 of the randomized controlled trials(RCT)were discovered including 1029 patients.Meta-analyses showed that compared with placebo treatment the left ventricular ejection fraction of the stem cells group was improved[2.08,95% CI(1.04,3.13),P<0.0001];and the left ventricular end systolic diameter reduced[-5.16,95% CI(-7.64,-2.67),P<0.0001];but the left ventricular end diastolic diameter was not reduced[-1.65,95% CI(-4.92,1.61),P=0.32].Conclusions These finds demonstrate that bone marrow stem cells may be effective to improve the left ventricular function in patient after myocardial infarction,but it can’t improve the diastolic function.

关 键 词：骨髓祖代细胞 心肌梗死 随机对照试验 META分析 

分 类 号：R542.22[医药卫生—心血管疾病]