Autologous bone marrow stem cell therapy for patients undergoing coronary artery bypass grafting: A meta-analysis of 14 randomized controlled trials
Autologous bone marrow stem cell therapy for patients undergoing coronary artery bypass grafting: A meta-analysis of 14 randomized controlled trials
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DOI：
10.3892/etm.2019.7283
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发表时间：
2019-02
影响因子：
2.7
通讯作者：
Shanlian Wu;L. Yao;Peijing Yan;Qiangwei Bao;Xin Dong;Xingguang Liu;Yan Zhu;X. Su;Aqian Wang;Y. Duan;Kehu Yang;Min Zhang;Yunshan Cao
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作者：
Shanlian Wu;L. Yao;Peijing Yan;Qiangwei Bao;Xin Dong;Xingguang Liu;Yan Zhu;X. Su;Aqian Wang;Y. Duan;Kehu Yang;Min Zhang;Yunshan Cao
自体骨髓干细胞（BMSC）治疗是缺血性心脏病患者再生治疗的一种新选择。本荟萃分析的目的是评估 BMSC 联合冠状动脉旁路移植术 (CABG) 的有效性。检索了 PubMed、Cochrane Library、EMBASE 和 Web of Science 数据库中从建库到 2017 年 11 月 22 日有关 BMSC 治疗联合 CABG 的随机对照试验。最终纳入了 14 项试验，共有 596 名参与者。使用随机效应模型分析数据。与对照组相比，BMSC治疗组的左心室（LV）射血分数从基线到随访期间均有改善[平均差（MD）=4.36%； 95% 置信区间 (CI)：1.90–6.81%； P<0.01]。汇总结果分析显示，左心室舒张末期容积（MD=-6.27 ml；95% CI：-22.34 至 9.80 ml；P=0.44）、左心室舒张末期容积指数（MD=-15.11 ml/m2；95% CI：-31.53 至 1.30 ml/m2；P=0.07）无显着差异。 BMSC 组和单独 CABG 组之间的 LV 收缩末期容积（MD=−11.52 ml；95% CI：−26.97 至 3.93 ml；P=0.14）和 LV 收缩末期容积指数（MD=−16.56 ml/m2；95% CI：−37.75 至 4.63 ml/m2；P=0.13）。因此，与单独进行 CABG 相比，接受 CABG 患者的自体 BMSC 治疗似乎与左室功能的改善相关。
Autologous bone marrow stem cell (BMSC) therapy is a novel option for regenerative therapy in patients with ischemic heart disease. The aim of the present meta-analysis was to evaluate the effectiveness of BMSCs combined with coronary artery bypass grafting (CABG). The PubMed, Cochrane Library, EMBASE and Web of Science databases were searched from inception to November 22, 2017 for randomized controlled trials on BMSC therapy combined with CABG. Finally, 14 trials with a total of 596 participants were included. Data were analyzed using a random-effects model. Compared with the control group, the BMSC therapy group exhibited an improvement in the left ventricular (LV) ejection fraction from baseline to follow-up [mean difference (MD)=4.36%; 95% confidence interval (CI): 1.90–6.81%; P<0.01]. Analysis of the pooled results revealed non-significant differences in the LV end-diastolic volume (MD=−6.27 ml; 95% CI: −22.34 to 9.80 ml; P=0.44), LV end-diastolic volume index (MD=−15.11 ml/m2; 95% CI: −31.53 to 1.30 ml/m2; P=0.07), LV end-systolic volume (MD=−11.52 ml; 95% CI: −26.97 to 3.93 ml; P=0.14) and LV end-systolic volume index (MD=−16.56 ml/m2; 95% CI: −37.75 to 4.63 ml/m2; P=0.13) between the BMSC and CABG alone groups. Therefore, autologous BMSC therapy for patients undergoing CABG appears to be associated with an improvement in LV function compared with CABG alone.