Tao Huimin, Li Yafeng, Wang Tingting, Zhou Changhui
Department of Gastroenterology, Liaocheng People's Hospital, Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong Province, People's Republic of China.
Department of Health Care, Weifang People's Hospital, Weifang, Shandong Province, People's Republic of China.
Ther Clin Risk Manag. 2018 Feb 26;14:417-440. doi: 10.2147/TCRM.S157603. eCollection 2018.
The aim of the study was to evaluate the efficacy and safety of umbilical cord blood stem cells (USCs) transplantation combined with routine supportive therapy (RST) for liver cirrhosis (LC).
Clinical trials involved in this research were searched from Web of Science, PubMed, EMBASE, Cochrane Library, Wanfang and CNKI database. Treatment effects, quality of life (QoL), adverse events and other outcome measures were extracted and evaluated.
A total of 10 trials including 616 LC patients were involved in this study. Based on our analysis, the liver function of LC patients was significantly improved after USCs transplantation and RST combined therapy, indicated by decreased total bilirubin, alanine aminotransferase, aspartate aminotransferase levels and prothrombin time and increased serum albumin level and prothrombin activity. Compared to those treated by RST alone, patients treated by combined therapy showed more satisfied treatment effects, improved QoL reflected by improved appetite (odds ratio [OR]=5.43, 95% CI=2.84 to 10.38, <0.00001) and relieved fatigue (OR=4.33, 95% CI=0.87 to 21.60, =0.07), ascetic fluid (OR=4.56, 95% CI=2.69 to 7.74, <0.00001), abdominal distension (OR=4.01, 95% CI=1.34 to 12.02, =0.01) and edema (OR=2.69, 95% CI=0.23 to 31.72, =0.43). No serious adverse events occurred during USCs therapy.
USCs transplantation is a safe and effective adjuvant therapy for RST-treated LC, possibly through improving patients' liver function.
本研究旨在评估脐带血干细胞（USCs）移植联合常规支持治疗（RST）对肝硬化（LC）的疗效和安全性。
从Web of Science、PubMed、EMBASE、Cochrane图书馆、万方和知网数据库中检索本研究涉及的临床试验。提取并评估治疗效果、生活质量（QoL）、不良事件及其他结局指标。
本研究共纳入10项试验，涉及616例LC患者。基于我们的分析，USCs移植联合RST治疗后，LC患者的肝功能显著改善，表现为总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶水平及凝血酶原时间降低，血清白蛋白水平及凝血酶原活性升高。与单纯接受RST治疗的患者相比，联合治疗的患者治疗效果更令人满意，生活质量得到改善，表现为食欲改善（优势比[OR]=5.43，95%可信区间[CI]=2.84至10.38，<0.00001）、疲劳缓解（OR=4.33，95%CI=0.87至21.60，=0.07）、腹水（OR=4.56，95%CI=2.69至7.74，<0.00001）、腹胀（OR=4.01，95%CI=1.34至12.02，=0.01）和水肿（OR=2.69，95%CI=0.23至31.72，=0.43）。USCs治疗期间未发生严重不良事件。
USCs移植是RST治疗LC的一种安全有效的辅助治疗方法，可能是通过改善患者的肝功能实现的。
