间充质干细胞改善移植肾功能的Meta分析  

Mesenchymal stem cell transplantation for post-transplant renal function: a Meta-analysis

作　　者：陈城[1] 顾宇伟[1] 张俊[1] 胡林昆[1] 魏雪栋[1] 侯建全[1] 

机构地区：[1]苏州大学附属第一医院泌尿外科,江苏省苏州市215006

出　　处：《中国组织工程研究》2016年第36期5432-5439,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:近年来,新型免疫制剂的出现使移植肾的存活率不断提高,但免疫制剂的使用带来大量不良反应,且无法降低远期排斥发生率。间充质干细胞的研究正引起人们极大的兴趣,然而其在肾移植方向的临床应用有效性仍存在争议。目的:系统评价使用间充质干细胞对移植肾功能改善作用的有效性。方法:检索PubM ed,EMBASE,the Cochrane Library database,the Cochrane Central Register of Controlled Trials,中国期刊全文数据库(CNKI)及万方数据库,纳入肾移植后以间充质干细胞为基础的免疫方案治疗的随机对照试验,检索时间均从建库至2015年11月。获得相关研究数据后,用Revman5.3软件进行统计分析。结果与结论:(1)共纳入了6个随机对照试验,包括1 166例患者;(2)Meta分析结果显示,肾移植后1周、2周、1个月,间充质干细胞治疗组的肾小球滤过率估计值均高于对照组(P<0.05);(3)肾移植后1,3,6,12个月,间充质干细胞治疗组的血清肌酐水平与对照组相比差异均无显著性意义(P>0.05);(4)以上结果说明以间充质干细胞为基础的免疫治疗在肾移植后早期肾功能改善方面优于现阶段标准免疫治疗,但后期其临床优势不明显,具体原因有待大规模临床随机对照试验对其进一步验证。BACKGROUND： In recent years, with the use of new immunosuppressive agents, the survival rate of renal graft is greatly improved, but accompanied by lots of side effects and unchanged long-term graft survival. Mesenchymal stem cells（MSCs） have aroused people＇s great interest, while their efficacy in kidney transplantation remains controversial. OBJECTIVE： To evaluate the efficacy of MSCs transplantation on post-transplant renal graft function with a systematic review. METHODS： Pub Med, EMBASE, the Cochrane Library database, the Cochrane Central Register of Controlled Trials, Wanfang database and China National Knowledge Infrastructure（CNKI） were searched until November 2015. Revman 5.3 was used for statistical analysis. RESULTS AND CONCLUSION： A total of 6 randomized controlled trials were included, including 1 166 patients. Meta-analysis results showed that at 1, 2 weeks and 1 month after kidney transplantation, the posttransplantation estimated glomerular filtration rates in the MSC-treated group were significantly higher than those in the control group（P 〈0.05）. At 1, 3, 6, 12 months after kidney transplantation, the posttransplantation serum creatinine levels showed no significant difference between the MSC-treated group and the control group（P〉 0.05）. To conclude, MSC-based immunosuppression regimen is superior to current standard immunotherapy in improving renal graft function in the early stage after kidney transplantation, but the clinical efficacy is diminished in the later period. Therefore, further investigation using large-scale randomized controlled trials is warranted.

关 键 词：间质干细胞 肾移植 肾小球滤过率 肌酸酐 META分析 组织工程 干细胞 移植 间充质干细胞 血清肌酐 肾小球滤过率估计值 系统评价 

分 类 号：R394.2[医药卫生—医学遗传学]