干细胞治疗肝硬化的有效性和安全性：一项随机对照试验的荟萃分析。

Effectiveness and Safety of Stem Cell Therapy in Liver Cirrhosis: A Meta-Analysis of Randomized Controlled Trials.

出版信息

Altern Ther Health Med. 2024 Jun;30(6):246-253.

Abstract

OBJECTIVE

In recent years, stem cell transplantation (SCT) has been applied to the clinical treatment of patients with cirrhosis. The specialist clinic of the SCT clinic provides regular and effective interventions for cirrhosis, helping to improve patient management and compliance. The aim of this study was to determine the efficacy and safety of SCT in the treatment of cirrhosis.

METHODS

This systematic review adhered to the guidelines outlined in the PRISMA statement. The National Library of Medicin (MEDLINE), Excerpt Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), and Clinical Trials.gov databases were searched to screen liver cirrhosis-related articles with stem cell therapy from 2000 to 2022. The articles were then filtered and extracted for clinical outcomes including MELD score, Child-Pugh score, platelets, creatinine, bilirubin, albumin, international normalized ratio (INR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transferase (GGT), alkaline phosphatase (ALP), α fetoprotein (AFP), prothrombin time (PT). The data were normalized and analyzed using the standardized mean difference (SMD) and 95% confidence interval (CI).

RESULTS

A total of 1209 articles were searched, and from these, ten studies were selected for analysis regarding the association between SCT and the clinical outcomes of liver cirrhosis. The findings revealed that SCT therapy, in comparison to conventional treatment, resulted in a reduction in MELD score and INR after 1 month, a decrease in Child-Pugh score at 3 months, an increase in platelet count at 3 months, and an elevation in ALB levels after 1 month. However, no significant beneficial effects were observed on creatinine, bilirubin, PT, ALT, AST, GGT, ALP, and ASP levels.

CONCLUSION

This study suggested that SCT therapy could elevate the ALB levels and alleviate the MELD score and INR, short-term decreasing the Chile-Pugh score and increasing the platelet levels. It could be a potential therapeutic alternative for patients with cirrhosis.

摘要

目的

近年来，干细胞移植（SCT）已应用于肝硬化患者的临床治疗。SCT 临床专科门诊为肝硬化患者提供定期和有效的干预措施，有助于改善患者管理和依从性。本研究旨在确定 SCT 在肝硬化治疗中的疗效和安全性。

方法

本系统评价遵循 PRISMA 声明中概述的指南。从 2000 年到 2022 年，检索国家医学图书馆（MEDLINE）、医学文摘数据库（EMBASE）、 Cochrane 对照试验中心注册库（CENTRAL）和临床试验.gov 数据库，筛选与干细胞治疗相关的肝硬化学术论文。然后对文章进行筛选和提取，以获得包括 MELD 评分、Child-Pugh 评分、血小板、肌酐、胆红素、白蛋白、国际标准化比值（INR）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转移酶（GGT）、碱性磷酸酶（ALP）、α 胎蛋白（AFP）、凝血酶原时间（PT）在内的临床结局。使用标准化均数差（SMD）和 95%置信区间（CI）对数据进行归一化和分析。

结果

共检索到 1209 篇文章，从中选择了 10 项研究分析 SCT 与肝硬化临床结局的关系。结果表明，与常规治疗相比，SCT 治疗 1 个月后 MELD 评分和 INR 降低，3 个月后 Child-Pugh 评分降低，3 个月后血小板计数增加，1 个月后 ALB 水平升高。然而，肌酐、胆红素、PT、ALT、AST、GGT、ALP 和 ASP 水平无显著改善。