Bone marrow-derived mesenchymal stem cell therapy for decompensated liver cirrhosis: A meta-analysis
Bone marrow-derived mesenchymal stem cell therapy for decompensated liver cirrhosis: A meta-analysis
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DOI：
10.3748/wjg.v20.i38.14051
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发表时间：
2014-10-14
影响因子：
4.3
通讯作者：
Lai, Xiao-Huan
中科院分区：
文献类型：
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作者：
Pan, Xing-Nan;Zheng, Lian-Qiu;Lai, Xiao-Huan
目的：评价骨髓间充质干细胞（BM-MSC）治疗失代偿期肝硬化的疗效和安全性。方法：在Cochrane图书馆、Med-Line （Pub-Med）和Embase中使用搜索词“骨髓干细胞”、“慢性肝病”、“输血”和“注射”，在出版日期和语言方面没有任何限制。我们还手工检索了期刊，并联系了该领域的专家。使用骨髓间充质干细胞治疗任何慢性肝病的研究被纳入。使用Comprehensive Review Manager和Meta-Analyst软件进行统计分析。采用贝格检验评价发表偏倚。结果：在确定的78项研究中，有5项研究被纳入最终分析。这些研究在中国、伊朗、埃及和巴西进行。Review Manager对两项对照研究的汇总数据分析显示，输血后第2、4和24周，终末期肝病（MELD）模型评分的平均下降分别为-1.23 [95%CI: -2.45-(-0.01)]、-1.87 [95%CI: -3.16-(-0.58)]、-2.01 [95%CI: -3.35-(-0.68)]。5项研究的荟萃分析显示，输血后8、16、24和48周时，白蛋白水平的平均改善分别为-0.28、2.60、5.28、4.39 g/L。MELD评分、丙氨酸转氨酶、总胆红素水平和凝血酶原时间均有一定改善。BM-MSC注射未导致严重不良事件或并发症。结论：BM-MSC输注治疗失代偿期肝硬化可改善肝功能。在第1年结束时，没有出现严重的副作用或并发症。（三）2014年百世登出版集团股份有限公司版权所有。
AIM: To assess the efficacy and safety of bone marrow-derived mesenchymal stem cell (BM-MSC) in the treatment of decompensated liver cirrhosis.METHODS: The search terms "bone marrow stem cell" "chronic liver disease" "transfusion" and "injection" were used in the Cochrane Library, Med-Line (Pub-Med) and Embase without any limitations with respect to publication date or language. Journals were also hand-searched and experts in the field were contacted. The studies which used BM-MSC in the treatment of any chronic liver disease were included. Comprehensive Review Manager and Meta-Analyst software were used for statistical analysis. Publication bias was evaluated using Begg's test.RESULTS: Out of 78 studies identified, five studies were included in the final analysis. The studies were conducted in China, Iran, Egypt and Brazil. Analysis of pooled data of two controlled studies by Review Manager showed that the mean decline in scores for the model for end-stage liver disease (MELD) was -1.23 [95%CI: -2.45-(-0.01)], -1.87 [95%CI: -3.16-(-0.58)], -2.01 [95%CI: -3.35-(-0.68)] at 2, 4 and 24 wk, respectively after transfusion. Meta-analysis of the 5 studies showed that the mean improvement in albumin levels was -0.28, 2.60, 5.28, 4.39 g/L at the end of 8, 16, 24, and 48 wk, respectively, after transfusion. MELD scores, alanine aminotransferase, total bilirubin levels and prothrombin times improved to some extent. BM-MSC injections resulted in no serious adverse events or complications.CONCLUSION: BM-MSC infusion in the treatment of decompensated liver cirrhosis improved liver function. At the end of year 1, there were no serious side effects or complications. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.