骨髓干细胞移植治疗急性心肌梗死远期安全性的荟萃分析  

Long-term safety of bone marrow-derived cells transplantation in patientswith acute myocardial infarction:a meta-analysis

作　　者：陈龙[1] 童嘉毅[1] 金辉[2] 金虹[1] 卞叶萍[1] 沈祥波[1] 马根山[1] 

机构地区：[1]东南大学附属中大医院心内科,南京210009 [2]东南大学公共卫生学院流行病与卫生统计学系

出　　处：《临床心血管病杂志》2013年第4期268-271,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金(No:81070265);教育部高等学校博士学科点专项科研基金资助(No:20090092120059)

摘　　要：目的:对随访期2年或以上的临床随机对照试验进行荟萃分析,探讨骨髓干细胞移植治疗急性心肌梗死的远期安全性。方法:系统检索数据库MEDLINE,EMBASE,Cochrane图书馆和Cochrane对照试验注册中心及中国生物医学磁盘数据库。时间为从建库到2012年7月。用标准表格提取资料,应用RevMan 5.0软件进行定量分析。结果:6篇临床试验合计551例患者纳入本荟萃分析。与对照组相比,骨髓干细胞移植组在总死亡率、心血管死亡率、总血运重建率、靶血管血运重建率、室性心动过速或晕厥、肿瘤和脑卒中的发生率等方面有降低趋势,但差异无统计学意义;而骨髓干细胞移植组的心力衰竭所致住院率和心肌梗死的再发率较对照组显著降低。结论:骨髓干细胞移植治疗急性心肌梗死不增加主要临床不良事件的发生率,其安全性至少能保持到2年以上。该结果还需要未来大规模随机临床试验来证实。Objective：To investigate the long-term safety of bone marrow-derived cells（BMC） therapy in patients with acute myocardial infarction（AMI） by performing meta-analysis of clinical randomized controlled trials with follow-up ≥2 years. Method：Specific terms were used to conduct a systematic literature search of MEDLINE,EMBASE,the Cochrane Library and the Cochrane Central Register of Controlled Trials,and the China Biological Medicine Disk Database from their inception to July 2012.A standardized form was used to extract information,and RevMan version 5.0 was used to analyze outcome data quantitatively. Result：Six trials comprising 551 patients were included.Compared with controls,BMC treatment groups had trends of reduction for all-cause mortality,cardiovascular mortality,morbidity of all revascularizations,target vessel revascularization,ventricular tachycardia or syncope,cancer and stroke,but the differences were not statistically significant.The incidence of recurrent MI and heart failure-related hospitalization was significantly lower in BMC treatment groups. Conclusion：Without increasing major adverse events,BMC transplantation in patients with AMI seems to be safe,which could last at least 2 years.The findings need to be validated by large-scale randomized clinical trials in the future.

关 键 词：心肌梗死 安全性 骨髓干细胞 荟萃分析 

分 类 号：R542.2[医药卫生—心血管疾病]