摘要
目的系统评价冠状动脉旁路移植术（CABG）同期行骨髓干细胞（BMSC）移植对缺血性心脏病左室功能的疗效。方法计算机检索Pubmed、the coherence library、EMbase、CNKI和wanfangData数据库，搜集CABG与CABG同期BMSC移植对左室功能疗效的随机对照试验（RCT），检索时限均为建库至2017年1月。由2位研究员独立筛选文献、提取资料和评价纳入研究的偏倚风险，采用Revman5．3软件进行Meta分析。结果共纳入11个RCT，共441例患者。Meta分析结果显示，CABG同期BMSC移植与CABG组左室射血分数（LVEF）的改变量比较（MD=3．27，95％ CI-0．39-6．93），差异无统计学意义（P=0．08）。但按细胞类型亚组分析结果显示，与对照组比较，试验组在CD34＋高表达及无选择性骨髓干细胞移植时LVEF改变量 明显增加[CD34＋：MD=8．77，95％ CI 5．08-12．45，P〈0．01，无选择性骨髓干细胞移植：MD=4．28，95％ CI2．38-16．18，P〈0．01]，而CD133＋高表达组LVEF改变量 明显降低（MD=-4．56，95％CI-6．18～2．93，P〈0．01）。按随访时间是否长于6个月及术前LVEF是否大于35％为亚组进行分析，结果提示均未见统计学差异。结论CABG联合CD34＋或无选择性骨髓干细胞移植对缺血性心脏病患者左室射血分数的改善有肯定的疗效。
Objective To assess the therapeutic effects of BMCs transplantation with CABG in LVEF of ischemic heart disease. Methods Randomized controlled trials of BMSC in combination with coronary artery by- pass grafting（CABG） or for LVEF of IHD were identified by searching Pubmed, Embase, CNKI and WanFang Data from their inception to Jan 2017. Screening literature, extracting date and assessing the risk biase of including study was independently accomplished by two researcheres. Then revimen 5.3 software was used to perform meta- analysis. Results 11 RCTs involving 441 patients were included. Meta-analysis revealed that BMSC plus CABG group has no statistical significance in LVEF change compare to the CABG group（MD=3.27, 95%CI -0.39-6.93, P= 0.08 ）. However the analysis of different stem cell type showed CD34＋ and unselected stem cell group has more efficiently in increasing LVEFchange compare to the control group [CD34 ＋（MD=8.77, 95%CI 5.08-12.45, P〈0.01）, unselected stem cell （MD=4.28, 95%CI 2.38-6.18, P〈0.01）]. Nevertheless, left ventrieular ejection fraction in CD133＋ group was significantly lower （MD=-4.56, 95%CI -6.18--2.93, P〈0.01）. The analysis for subgroup whether preoperative LVEF〉35% and whether followed-up period over 6 months was no statistical significance. Conclusion Coronary artery bypass grafting combined bone marrow stem cells transplantation treatment have beneficial effect on the left ventficular function in patients with ischemic heart disease.
出处
《中国心血管病研究》
CAS
2017年第10期932-937,共6页
Chinese Journal of Cardiovascular Research
关键词
冠状动脉旁路移植术
骨髓干细胞
左心室功能
Coronary artery bypass grafting
Bone marrow stem cell
Left ventricular function
