Shanghai Jiaotong University, Ruijin Hospital, Department of Cardiac Surgery, Shanghai 200025, PR China.
Expert Opin Biol Ther. 2011 Dec;11(12):1569-79. doi: 10.1517/14712598.2011.616491. Epub 2011 Oct 8.
Whether adult bone marrow (BM)-derived cells (BMCs) transplantation benefits patients with chronic ischemic heart disease (IHD) remains controversial. This systemic and meta-analysis study aimed to assess the potential therapeutic effects of BMCs transplantation with revascularization in chronic IHD.
Randomized controlled trials of BMCs in combination with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) for chronic IHD were identified by searching Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library, and the Web of Science. We conducted a random-effects meta-analysis across eligible studies measuring the same outcomes.
Ten randomized controlled trials including 422 participants were reviewed. In the trials with six months of follow-up, BMCs transplantation improved left ventricular (LV) ejection fraction (LVEF) by 4.02% and reduced LV end-systolic and end-diastolic volumes. Subgroup analysis revealed a statistically significant difference in LVEF associated with primary intervention, route of cell delivery, cell type, and baseline LVEF, but not with cell dose or storage duration.
Selected-BMCs transplantation through myocardial injection after surgical revascularization may benefit patients with chronic IHD and severely impaired LV function. Due to the limitation of patient number, RCT with larger sample size and long follow-up are required for future research.
成人骨髓（BM）来源细胞（BMC）移植是否有益于慢性缺血性心脏病（IHD）患者仍存在争议。本系统评价和荟萃分析旨在评估 BMC 移植联合血管再通治疗慢性 IHD 的潜在疗效。
通过检索 Medline、Embase、Cochrane 对照试验登记处、Cochrane 图书馆和 Web of Science，确定了 BMC 联合冠状动脉旁路移植术（CABG）或经皮冠状动脉介入治疗（PCI）治疗慢性 IHD 的随机对照试验。我们对符合条件的研究进行了随机效应荟萃分析，以测量相同的结局。
共纳入了 10 项随机对照试验，共 422 名参与者。在随访 6 个月的试验中，BMC 移植使左心室射血分数（LVEF）提高了 4.02%，并降低了左心室收缩末期和舒张末期容积。亚组分析显示，与主要干预、细胞输送途径、细胞类型和基线 LVEF 相关的 LVEF 存在统计学差异，但与细胞剂量或储存时间无关。
通过外科血管再通后的心肌内注射选择 BMC 移植可能有益于慢性 IHD 和严重左心室功能障碍的患者。由于患者数量有限，未来的研究需要进行更大样本量和更长随访时间的 RCT。
