骨髓干细胞移植对急性心肌梗死远期左室收缩功能影响的Meta分析
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国家自然科学基金(81070083?81070265);教育部高等学校博士学科点专项科研基金(20090092120059)


Long-term effect of bone marrow-derived cells transplantation on left ventricular systolic function in patients with acute myocardial infarction:a meta-analysis
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    目的:对随访期2年或以上的随机对照试验进行Meta分析,探讨骨髓干细胞(BMC)移植对急性心肌梗死后患者远期左室收缩功能的影响-方法:系统检索数据库Medline-Embase-Cochrane图书馆和Cochrane对照试验注册中心-中国生物医学磁盘数据库;时间为从建库到2012年7月-用统一表格提取资料,应用RevMan 5.0软件进行定量分析-结果:6篇临床试验合计551名患者纳入本Meta分析-与对照组相比,BMC移植使左室射血分数(LVEF)显著增加(5.09%,95%CI:2.67%~7.52%,P < 0.001)-亚组分析显示,基线LVEF低于42%的患者从BMC治疗中获益明显,LVEF显著改善,而基线LVEF高于42%的患者未能从中获益-结论:BMC移植能够在标准治疗的基础上进一步增加急性心肌梗死后的LVEF,改善左室收缩功能,该效应至少能保持2年以上-该效应还需要未来大规模随机对照试验来证实-

    Abstract:

    Objective:To investigate the long-term effect of bone marrow-derived cells (BMC) therapy on left ventricular systolic function in patients after acute myocardial infarction (AMI) by performing meta-analysis of randomized controlled trials with follow-up ≥2 years. 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 July 2012. A standardized form was used to extract information,and RevMan version 5.0 was used to analyze outcome data quantitatively. Results:Six trials comprising 551 patients were included. Compared with controls,BMC therapy significantly improved left ventricular ejection fraction (LVEF) (5.09%,95% CI:2.67% to 7.52%,P < 0.000 1). Subgroup analysis revealed that significant improvement of LVEF induced by BMC therapy could be observed in patients with baseline LVEF≤42%,but disappeared in those with baseline LVEF> 42%. Conclusion:Intracoronary BMC infusion in patients with AMI may further increase LVEF and improve left ventricular systolic function on top of standard therapy,and beneficial effects could last for more than 2 years. The findings need to be validated in the future.

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陈 龙,童嘉毅,金 辉,金 虹,魏 芹,李拥军,马根山.骨髓干细胞移植对急性心肌梗死远期左室收缩功能影响的Meta分析[J].南京医科大学学报(自然科学版),2014,(2):260-264

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  • 收稿日期:2013-06-26
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  • 在线发布日期: 2014-03-03
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