Wang Chao, Han Xiujiang, Li Yongjian, Zhang Boya
Department of Cardiology, Tianjin Nankai Hospital, Tianjin, China.
Medicine (Baltimore). 2018 Apr;97(16):e0359. doi: 10.1097/MD.0000000000010359.
Bone marrow mononuclear cell (BMMNC) therapy has been used as an adjunctive treatment in patients with ST-elevated myocardial infarction (STEMI). However, the therapeutic efficacy of this approach remains controversial. The present meta-analysis is aimed to evaluate the impact of cell therapy on left ventricular function after STEMI.
We searched through PubMed and EMBASE databases till 2017 for all relevant publications using certain search terms. Randomized controlled trials investigating the effect of BMMNC therapy in patients with STEMI who underwent percutaneous coronary intervention were selected. Wall motion score index (WMSI), infarct size, wall thickening, and myocardial perfusion were our endpoints.
A total of 24 trials with 1536 patients were included in our study. Overall, as observed in our data, cell therapy reduced infarct size by -2.32 (95% confidence interval [CI] -4.03, -0.62; P = .007; I = 24%) and improved myocardial perfusion by -3.04 (95% CI -3.94, -2.15; P < .001; I = 0%). However, there was no significant difference between treatment group and control group in WMSI or wall thickening.
Intracoronary BMMNC infusion is safe for patients with STEMI. It is also associated with improvement of infarct size and myocardial perfusion. Further multicenter randomized trials should be conducted to validate the therapeutic efficacy of this treatment.
骨髓单个核细胞（BMMNC）疗法已被用作ST段抬高型心肌梗死（STEMI）患者的辅助治疗。然而，这种方法的治疗效果仍存在争议。本荟萃分析旨在评估细胞治疗对STEMI后左心室功能的影响。
我们使用特定检索词在PubMed和EMBASE数据库中检索至2017年的所有相关出版物。选择调查BMMNC疗法对接受经皮冠状动脉介入治疗的STEMI患者疗效的随机对照试验。我们的终点指标为壁运动评分指数（WMSI）、梗死面积、室壁增厚和心肌灌注。
我们的研究共纳入24项试验，涉及1536例患者。总体而言，如我们的数据所示，细胞治疗使梗死面积减少了-2.32（95%置信区间[CI]-4.03，-0.62；P = 0.007；I = 24%），并使心肌灌注改善了-3.04（95% CI -3.94，-2.15；P < 0.001；I = 0%）。然而，治疗组与对照组在WMSI或室壁增厚方面无显著差异。
冠状动脉内注入BMMNC对STEMI患者是安全的。它还与梗死面积和心肌灌注的改善相关。应进行进一步的多中心随机试验以验证这种治疗的疗效。
