Long-term effects of bone marrow-derived cells transplantation in patients with acute myocardial infarction: a meta-analysis
Long-term effects of bone marrow-derived cells transplantation in patients with acute myocardial infarction: a meta-analysis
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骨髓源性细胞移植对急性心肌梗死患者的长期影响：荟萃分析
DOI：
10.3760/cma.j.issn.0366-6999.20121532
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发表时间：
2013-01-20
影响因子：
6.1
通讯作者：
Ma Gen-shan
中科院分区：
文献类型：
--
作者：
Chen Long;Tong Jia-yi;Ma Gen-shan
背景：骨髓衍生细胞(BMC)移植治疗急性心肌梗死(AMI)的远期疗效尚未确定。采用Meta分析方法对急性心肌梗死患者骨髓基质细胞治疗的远期疗效进行Meta分析。方法以特定术语检索MEDLINE、EMBASE、Cochrane图书馆和Cochrane中央对照试验数据库及中国生物医学光盘数据库，检索时间为2年。采用标准化方案提取信息，使用随机效应模型分析除主要不良事件外的所有资料。与对照组相比，骨髓基质细胞治疗组的左心室射血分数显著增加(4.18%，95%CI：2.02%~6.35%，P=0.0002)，而左心室收缩末期容量(-4.47ml，95%CI：10.92~1.99，P=0.17)和左室舒张末容量(-2.29ml，95%CI：9.96~5.39，P=0.56)略有下降。亚组分析显示，基础LVEF42%的患者经BMC治疗后，LVEF值明显改善。结论急性心肌梗死患者冠状动脉内输注BMC似乎是安全的，可以在常规治疗的基础上进一步改善LVEF，尤其是有益效果可持续很长时间。这些发现需要在未来得到验证。
Background The long-term effects of bone marrow-derived cells (BMC) transplantation in patients with acute myocardial infarction (AMI) have not been established. The present meta-analysis of randomized controlled trials with follow-up >= 2 years was performed to investigate the long-term effects of BMC therapy in patients after AMI.Methods 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 March 2012. A standardized protocol was used to extract information, and random effect model was used to analyze all data except major adverse events.Results Five trials comprising 510 patients were included. Compared with controls, BMC therapy significantly improved left ventricular ejection fraction (LVEF) (4.18%, 95% CI: 2.02% to 6.35%, P=0.0002), while mildly but not significantly reduced left ventricular end-systolic volume (-4.47 ml, 95% CI: 10.92 to 1.99, P=0.17) and left ventricular end-diastolic volume (-2.29 ml, 95% CI: 9.96 to 5.39, P=0.56). Subgroup analysis revealed that significant improvement of LVEF induced by BMC therapy could be observed in patients with baseline LVEF 42%. There were trends in favor of BMC therapy for most major clinical adverse events, though most differences were not significant.Conclusions Intracoronary BMC infusion in patients with AMI seems to be safe and may further improve LVEF on top of standard therapy; especially the beneficial effects could last for long term. The findings need to be validated in the future.