Wu Shanlian, Yao Liang, Yan Peijing, Bao Qiangwei, Dong Xin, Liu Xingguang, Zhu Yan, Su Xin, Wang Aqian, Duan Yichao, Yang Kehu, Zhang Min, Cao Yunshan
Department of Pathology, School of Basic Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu 730000, P.R. China.
Department of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu 730000, P.R. China.
Exp Ther Med. 2019 Apr;17(4):2985-2994. doi: 10.3892/etm.2019.7283. Epub 2019 Feb 15.
Autologous bone marrow stem cell (BMSC) therapy is a novel option for regenerative therapy in patients with ischemic heart disease. The aim of the present meta-analysis was to evaluate the effectiveness of BMSCs combined with coronary artery bypass grafting (CABG). The PubMed, Cochrane Library, EMBASE and Web of Science databases were searched from inception to November 22, 2017 for randomized controlled trials on BMSC therapy combined with CABG. Finally, 14 trials with a total of 596 participants were included. Data were analyzed using a random-effects model. Compared with the control group, the BMSC therapy group exhibited an improvement in the left ventricular (LV) ejection fraction from baseline to follow-up [mean difference (MD)=4.36%; 95% confidence interval (CI): 1.90-6.81%; P<0.01]. Analysis of the pooled results revealed non-significant differences in the LV end-diastolic volume (MD=-6.27 ml; 95% CI: -22.34 to 9.80 ml; P=0.44), LV end-diastolic volume index (MD=-15.11 ml/m; 95% CI: -31.53 to 1.30 ml/m; P=0.07), LV end-systolic volume (MD=-11.52 ml; 95% CI: -26.97 to 3.93 ml; P=0.14) and LV end-systolic volume index (MD=-16.56 ml/m; 95% CI: -37.75 to 4.63 ml/m; P=0.13) between the BMSC and CABG alone groups. Therefore, autologous BMSC therapy for patients undergoing CABG appears to be associated with an improvement in LV function compared with CABG alone.
自体骨髓干细胞(BMSC)疗法是缺血性心脏病患者再生治疗的一种新选择。本荟萃分析的目的是评估BMSC联合冠状动脉旁路移植术(CABG)的有效性。检索了PubMed、Cochrane图书馆、EMBASE和科学网数据库,从建库至2017年11月22日,查找关于BMSC疗法联合CABG的随机对照试验。最终,纳入了14项试验,共596名参与者。采用随机效应模型进行数据分析。与对照组相比,BMSC治疗组从基线到随访时左心室(LV)射血分数有所改善[平均差(MD)=4.36%;95%置信区间(CI):1.90 - 6.81%;P<0.01]。汇总结果分析显示,BMSC组与单纯CABG组在左心室舒张末期容积(MD=-6.27 ml;95% CI:-22.34至9.80 ml;P=0.44)、左心室舒张末期容积指数(MD=-15.11 ml/m;95% CI:-31.53至1.30 ml/m;P=0.07)、左心室收缩末期容积(MD=-11.52 ml;95% CI:-26.97至3.93 ml;P=0.14)和左心室收缩末期容积指数(MD=-16.56 ml/m;95% CI:-37.75至4.63 ml/m;P=0.13)方面无显著差异。因此,与单纯CABG相比,对接受CABG的患者进行自体BMSC治疗似乎与左心室功能改善有关。