Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
J Cardiothorac Surg. 2022 Jun 25;17(1):167. doi: 10.1186/s13019-022-01838-2.
Although the safety and feasibility of coronary artery bypass grafting (CABG) and bone marrow stem cell (BMSC) transplantation have been established, the effectiveness of this approach compared with CABG alone remains controversial. The aim of this updated meta-analysis of randomized controlled trials was to evaluate the efficacy of this procedure.
A random-effects meta-analysis was conducted using studies sourced from the PubMed, Embase, and Cochrane literature databases to compare patients who received isolated CABG (CABG group) and BMSC transplantation with CABG (BMSC group). 22 studies were included.
A total of 22 relevant publications with 820 patients were included. 432 patients received BMSC transplantation with CABG and 388 patients received isolated CABG. Compared with the CABG group, the BMSC transplantation group exhibited an improvement in the left ventricular (LV) ejection fraction (mean difference (MD) = 3.87%; 95% confidence interval (CI): 1.93-5.80%; P < 0.001).
The present evidence suggests that autologous BMSC transplantation for patients undergoing CABG appears to be associated with an improvement in LV function compared with CABG alone. However, heterogeneity in the data suggests that patients respond differently to this therapy. Further research is needed to understand these differences.
虽然冠状动脉旁路移植术(CABG)和骨髓间充质干细胞(BMSC)移植的安全性和可行性已得到证实,但与单独 CABG 相比,这种方法的有效性仍存在争议。本项更新的随机对照试验荟萃分析旨在评估该操作的疗效。
我们对来自 PubMed、Embase 和 Cochrane 文献数据库的研究进行了随机效应荟萃分析,比较了接受单纯 CABG(CABG 组)和 CABG 联合 BMSC 移植(BMSC 组)的患者。共纳入 22 项研究。
共纳入 22 项相关研究,共计 820 例患者。432 例患者接受了 CABG 联合 BMSC 移植,388 例患者接受了单纯 CABG。与 CABG 组相比,BMSC 移植组的左心室射血分数(LV 射血分数)得到改善(平均差值(MD)=3.87%;95%置信区间(CI):1.93-5.80%;P<0.001)。
目前的证据表明,与单纯 CABG 相比,CABG 患者自体 BMSC 移植似乎与 LV 功能的改善相关。但是,数据的异质性表明,患者对这种治疗的反应不同。需要进一步的研究来了解这些差异。