间充质干细胞修复大动物模型脊髓损伤疗效评价的Meta分析  

Efficacy of mesenchymal stem cells in the spinal cord injury of large animal models:a meta-analysis

作　　者：孔德胜[1,2] 何晶晶 冯宝峰 郭瑞云[1,2] Asiamah Ernest Amponsah 吕飞 张舒涵 张晓琳 马隽 崔慧先[1,2,4] Kong Desheng;He Jingjing;Feng Baofeng;Guo Ruiyun;Asiamah Ernest Amponsah;LüFei;Zhang Shuhan;Zhang Xiaolin;Ma Jun;Cui Huixian(Hebei Medical University-National University of Ireland Galway Stem Cell Research Center,Shijiazhuang 050017,Hebei Province,China;Hebei Research Center for Stem Cell Medical Translational Engineering,Shijiazhuang 050017,Hebei Province,China;Department of Epidemiology and Health Statistics,Shijiazhuang 050017,Hebei Province,China;Department of Anatomy,Hebei Medical University,Shijiazhuang 050017,Hebei Province,China)

机构地区：[1]河北医科大学-爱尔兰国立高威大学干细胞研究中心,河北省石家庄市050017 [2]河北省干细胞医学转化工程研究中心,河北省石家庄市050017 [3]河北医科大学流行病与卫生统计学教研室,河北省石家庄市050017 [4]河北医科大学解剖教研室,河北省石家庄市050017

出　　处：《中国组织工程研究》2021年第7期1142-1148,共7页Chinese Journal of Tissue Engineering Research

基　　金：河北省高层次人才资助项目(B2019005009),项目负责人:孔德胜;国家自然科学基金青年项目(81801278),项目负责人:马隽;河北省自然科学基金面上项目(H2019206637),项目负责人:马隽。

摘　　要：目的:间充质干细胞移植作为具有发展前景的脊髓损伤治疗方法之一,目前大多集中于小动物模型相关研究,大动物实验开展较少,并且对干细胞的种类选择与治疗效果仍存在争议。文章通过Meta分析间充质干细胞对大动物模型脊髓损伤相关指标的影响,评价其对脊髓损伤修复的作用。方法:计算机检索PubMed、Cochrane、OVID、Web of Science和中国知网,检索时限从建库起至2019年12月,收集关于间充质干细胞治疗大动物脊髓损伤的系列研究。由2位研究者按照纳入标准独立完成文献筛选、资料提取及方法学质量评价,采用Stata16.0进行Meta分析。结果:最终10篇文献纳入研究,Meta分析结果显示:①间充质干细胞可显著改善脊髓损伤后运动功能[I2=97.73%,MD=3.94,95%CI(2.15,5.72),P<0.01],并根据细胞来源、观察时间、移植时机、移植方式和移植类型分不同进行亚组分析:骨髓间充质干细胞组、非骨髓间充质干细胞组、短时间观察组(<2个月)、长时间观察组(≥2个月)、急性期移植组、非急性期移植组、单纯细胞移植组、异种移植组的运动评分明显高于对照组(P<0.01);而支架复合移植组运动评分相较对照组,差异无显著性意义(P>0.05);②间充质干细胞治疗组的损伤面积明显小于对照组[I2=98.05%,MD=-1.00,95%CI(-1.95,-0.04),P=0.04];③间充质干细胞治疗组与对照组之间胶质纤维酸性蛋白相对表达量差异无显著性意义[I2=99.48%,MD=80.61,95%CI(-27.48,188.70),P=0.14]。结论:间充质干细胞移植治疗对大动物脊髓损伤的运动功能和损伤修复有明显改善作用,且安全性较高。受纳入文献质量的限制,以上结论需更高质量、更大样本的随机对照实验加以验证。OBJECTIVE:Mesenchymal stem cells transplantation is a promising treatment for spinal cord injury.Most of studies focused on small animal models.In large animal experiments,there are still controversies in selection of stem cells and therapeutic effect.This article analyzed the effects of mesenchymal stem cells on related indicators of spinal cord injury in large animal models and evaluated their effects on spinal cord injury repair.METHODS:PubMed,Cochrane,OVID,Web of Science and CNKI databases were retrieved before December 2019.A series of studies on the treatment of spinal cord injury in large animal models by mesenchymal stem cells were collected.According to the inclusion criteria,two researchers independently completed literature screening,data extraction and methodological quality evaluation,and meta-analysis was conducted with Stata16.0.RESULTS:A total of 10 articles were included.The results of meta-analysis showed that:(1)Mesenchymal stem cells could significantly improve motor function after spinal cord injury[I2=97.73%,MD=3.94,95%CI(2.15,5.72),P<0.01].Based on cell source,observation time,intervention phase,transplantation mode and graft type subgroup analysis showed that motor scores of bone marrow mesenchymal stem cells group,non-bone marrow mesenchymal stem cells group,short-term observation(<2 months)group,long-term observation(≥2 months)group,acute stage group,non-acute stage group,cells group and allograft group were significantly higher than those of control group(P<0.01).There was no significant difference in motor score between scaffold group and control group(P>0.05).(2)The injury size in mesenchymal stem cells treatment group was significantly smaller than that in the control group[I2=98.05%,MD=-1.00,95%CI(-1.95,-0.04),P=0.04].(3)There was no significant difference in the relative expression of glial fibrillary acidic protein between the mesenchymal stem cells treatment group and the control group[I2=99.48%,MD=80.61,95%CI(-27.48,188.70),P=0.14].CONCLUSION:Mesenchymal stem cells transplanta

关 键 词：干细胞 间充质干细胞 脊髓损伤 大动物 实验 运动功能 蛋白 META分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]