Medical School of Nanjing University, Center for Translational Medicine, Nanjing, China.
Expert Opin Biol Ther. 2012 Dec;12(12):1563-73. doi: 10.1517/14712598.2012.721764. Epub 2012 Sep 6.
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).
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.
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.
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.
本荟萃分析旨在评估骨髓单个核细胞（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）患者的心脏功能参数。
从网络数据库中搜索相关的随机对照试验（RCT）。使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均数差值。
13 项 RCT 符合纳入标准。与对照组相比，BMMNC 治疗可使缺血性心脏病患者的 LVEF 提高 3.83%（95%置信区间：2.10-5.56%；p<0.0001）。值得注意的是，与 IHD 相比，IHF 患者的临床状况更为严重，BMMNC 治疗在改善 LVEF 方面似乎更为有效。虽然 IHF 患者的 LVEF 增加了 5.67%（95%置信区间：3.65-7.69%；p<0.00001），但 IHD 患者的 LVEF 仅增加了 2.19%（95%置信区间：0.37-4.00%；p=0.02）。
BMMNC 治疗与常规治疗相比，可使 IHD 和 IHF 患者的 LVEF 适度但显著改善。因此，这一观察结果支持进一步开展 RCT，以长期随访的方式评估 BMMNC 治疗的安全性和有效性。
