Bone marrow-derived mononuclear cell therapy for patients with ischemic heart disease and ischemic heart failure

Bone marrow-derived mononuclear cell therapy for patients with ischemic heart disease and ischemic heart failure
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骨髓源性单核细胞治疗缺血性心脏病和缺血性心力衰竭患者

DOI:
10.1517/14712598.2012.721764
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发表时间:
2012-11
影响因子:
4.6
通讯作者:
Gao, Qian
Gao, Qian
中科院分区:
医学3区
文献类型:
--
作者:
Wen, Yanting;Chen, Bing;Wang, Chen;Ma, Xiaodong;Gao, Qian

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目的:这项荟萃分析旨在评估骨髓来源的单核细胞(BMMNC)治疗是否可以改善缺血性心脏病(IHD)或缺血性心力衰竭(IHF)患者的心功能参数。方法:检索网络数据库中的相关随机对照试验(RCT)。采用随机效应模型计算左心室射血分数(LVEF)、左心室舒张末期和收缩末期容积变化的加权平均差异。结果:13篇RCT符合纳入标准。与对照组相比,BMMNCs治疗使缺血性心脏病患者的LVEF改善了3.83%(95%置信区间(CI):2.10 - 5.56%; p < 0.0001)。值得注意的是,在IHF患者中,与IHD相比,IHF是一种更严重的临床疾病,BMMNC治疗在LVEF改善方面似乎更有效。IHF患者的LVEF增加了5.67%(95% CI:3.65 - 7.69%; p < 0.00001),而IHD患者仅增加了2.19%(95% CI:0.37 - 4.00%; p = 0.02)。结论:在IHD和IHF患者中,BMMNCs治疗与LVEF的常规治疗中度但显著改善相关。因此,这一观察结果支持进一步的RCT进行长期随访的BMMNC治疗的安全性和有效性。
Objective: This meta-analysis aimed to assess whether bone marrow-derived mononuclear cells (BMMNCs) therapy may improve cardiac functional parameters in patients with ischemic heart disease (IHD) or ischemic heart failure (IHF). Methods: Relevant randomized controlled trials (RCTs) were searched from web databases. Weighted mean difference was calculated for changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volumes by using a random effects model. Results: 13 RCTs met inclusion criteria. Compared with controls, BMMNCs therapy improved LVEF by 3.83% (95% confidence interval (CI): 2.10 – 5.56%; p < 0.0001) in patients with ischemic heart conditions. Notably, in patients with IHF, a more severe clinical condition when compared with IHD, BMMNCs therapy appeared more effective in LVEF improvement. While LVEF increased by 5.67% (95% CI: 3.65 – 7.69%; p < 0.00001) in IHF patients, it only increased by 2.19% (95% CI: 0.37 – 4.00%; p = 0.02) in patients with IHD. Conclusions: BMMNCs therapy is associated with moderate but significant improvement over regular therapy in LVEF in patients with IHD and IHF. This observation, therefore, supports further RCTs conducting safety and efficiency of BMMNCs therapy with longer-term follow-up.
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发表时间: 2005-04-20
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