Combination of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in the treatment of knee osteoarthritis: a meta-analysis of randomised controlled trials.
Combination of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) in the treatment of knee osteoarthritis: a meta-analysis of randomised controlled trials.
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DOI：
10.1136/bmjopen-2022-061008
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发表时间：
2022-11-16
期刊：
影响因子：
2.9
通讯作者：
Zeng, Ling-Feng
中科院分区：
文献类型：
--
作者：
Zhao, Jinlong;Liang, Guihong;Han, Yanhong;Yang, Weiyi;Xu, Nanjun;Luo, Minghui;Pan, Jianke;Liu, Jun;Zeng, Ling-Feng
本荟萃分析旨在探讨骨髓间充质干细胞（MSCs）联合富血小板血浆（PRP）治疗膝骨关节炎（KOA）的有效性和安全性。系统回顾和荟萃分析. KOA患者使用MSC +PRP。视觉疼痛量表（VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、膝关节损伤和骨关节炎结局评分（KOOS）和不良反应。检索了PubMed、科克伦图书馆、Embase和中国国家知识基础设施（China National Knowledge Infrastructure），检索时间为从开始到2021年7月15日。计算相关结局指标的OR或加权均数差（WMD）。使用偏倚风险评估工具2.0版评价研究质量。通过计算I2来评价研究间的异质性。如果I2<50%，则应用固定效应模型;相反，如果I2 ≥ 50%，则应用随机效应模型。纳入6项对照临床试验，493例病例。荟萃分析结果显示，就治疗后3个月的VAS评分而言，与对照组（p=0.09）、透明质酸（HA）（p=0.15）或PRP单药组（p=0.07）相比，MSCs+PRP对KOA患者VAS评分的降低无显著影响。MSCs+PRP在治疗后6个月和12个月的VAS评分降低方面比对照组更有效（WMD=−0.55，95%CI −0.87至−0.22，p<0.001）、HA（WMD=−1.20，95%CI −2.28至−0.13，p=0.03）或PRP单独给药（WMD=−0.54，95%CI −0.89至−0.18，p=0.003）。关于治疗后3个月和6个月总WOMAC评分的降低，MSC +PRP显示出比对照或单独HA更好的临床疗效（p<0.01）。与对照组相比，MSC +PRP在治疗后12个月降低WOMAC总评分方面无显著差异（p=0.39）。在治疗后12个月的KOOS改善方面，MSC +PRP与对照组之间无显著差异（p=0.16）。与单独的MSC相比，MSC +PRP在治疗后12个月的不良反应发生率方面没有显着差异（p=0.22）。骨髓间充质干细胞+富血小板血浆治疗在改善膝骨性关节炎患者疼痛和关节功能方面显示出良好的临床疗效。与单独使用MSCs相比，MSCs+PRP的不良反应发生率无显著差异。CRD 42021275830。
The purpose of this meta-analysis was to investigate the efficacy and safety of mesenchymal stem cells (MSCs) combined with platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA). Systematic review and meta-analysis. Patients with KOA. Use of MSCs+PRP. Visual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and adverse reactions. PubMed, Cochrane Library, Embase and China National Knowledge Infrastructure were searched from inception to 15 July 2021. The OR or weighted mean difference (WMD) of relevant outcome indicators was calculated. Study quality was evaluated using the risk-of-bias assessment tool version 2.0. Heterogeneity among studies was evaluated by calculating I2. If I2＜50%, a fixed-effect model was applied; conversely, if I2 ≥50%, a random-effect model was applied. Six controlled clinical trials with 493 cases were included. The meta-analysis results showed that in terms of the VAS score 3 months after treatment, MSCs+PRP had no significant effect on the reduction of the VAS score in patients with KOA compared with the control (p=0.09), hyaluronic acid (HA) (p=0.15) or PRP alone (p=0.07). MSCs+PRP was more effective in reducing the VAS score at 6 and 12 months after treatment than the control (WMD=−0.55, 95% CI −0.87 to −0.22, p<0.001), HA (WMD=−1.20, 95% CI −2.28 to −0.13, p=0.03) or PRP alone (WMD=−0.54, 95% CI −0.89 to −0.18, p=0.003). Regarding the decrease in the total WOMAC score at 3 and 6 months after treatment, MSCs+PRP showed better clinical efficacy than the control or HA alone (p<0.01). Compared with the control, MSCs+PRP exhibited no significant difference in reducing the total WOMAC score 12 months after treatment (p=0.39). There was no significant difference between MSCs+PRP and the control in terms of improvement of the KOOS 12 months after treatment (p=0.16). Compared with MSCs alone, MSCs+PRP exhibited no significant difference in the incidence of adverse reactions (p=0.22) 12 months after treatment. Treatment with MSCs+PRP showed good clinical efficacy in improving pain and joint function in patients with KOA. Compared with MSCs alone, there was no significant difference in the incidence of adverse reactions with MSCs+PRP. CRD 42021275830.
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影响因子：
15.8
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
Hanaee Ahvaz H
DOI：
10.4084/mjhid.2010.005
发表时间：
2010-04-20
影响因子：
3.2
作者：
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Brain T