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干细胞治疗急性心肌梗死的中远期疗效及安全性的系统评价和荟萃分析。

Mid- to long-term efficacy and safety of stem cell therapy for acute myocardial infarction: a systematic review and meta-analysis.

机构信息

College of Nursing, Research Institute of AI and Nursing Science, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon, 21936, South Korea.

Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.

出版信息

Stem Cell Res Ther. 2024 Sep 11;15(1):290. doi: 10.1186/s13287-024-03891-1.

Abstract

BACKGROUND

This comprehensive systematic review and meta-analysis investigated the mid- to long-term efficacy and safety of stem cell therapy in patients with acute myocardial infarction (AMI).

METHODS

The study encompassed 79 randomized controlled trials with 7103 patients, rendering it the most up-to-date and extensive analysis in this field. This study specifically focused on the impact of stem cell therapy on left ventricular ejection fraction (LVEF), major adverse cardiac events (MACE), and infarct size.

RESULTS

Stem cell therapy significantly improved LVEF at 6, 12, 24, and 36 months post-transplantation compared to control values, indicating its potential for long-term cardiac function enhancement. A trend toward reduced MACE occurrence was observed in the intervention groups, suggesting the potential of stem cell therapy to lower the risk of cardiovascular death, reinfarction, and stroke. Significant LVEF improvements were associated with long cell culture durations exceeding 1 week, particularly when combined with high injected cell quantities (at least 10 cells). No significant reduction in infarct size was observed.

CONCLUSIONS

This review highlights the potential of stem cell therapy as a promising therapeutic approach for patients with AMI, offering sustained LVEF improvement and a potential reduction in MACE risk. However, further research is required to optimize cell culture techniques, determine the optimal timing and dosage, and investigate procedural variations to maximize the efficacy and safety of stem cell therapy in this context.

摘要

背景

本项全面的系统评价和荟萃分析调查了干细胞疗法在急性心肌梗死(AMI)患者中的中至长期疗效和安全性。

方法

该研究纳入了 79 项随机对照试验,共 7103 例患者,是该领域中最新和最全面的分析。本研究特别关注了干细胞疗法对左心室射血分数(LVEF)、主要不良心脏事件(MACE)和梗死面积的影响。

结果

与对照组相比,干细胞疗法在移植后 6、12、24 和 36 个月时显著提高了 LVEF,表明其具有长期改善心脏功能的潜力。干预组中观察到 MACE 发生的趋势降低,表明干细胞疗法可能降低心血管死亡、再梗死和中风的风险。与细胞培养时间超过 1 周且同时注入细胞数量较高(至少 10 个细胞)相关的 LVEF 显著改善。未观察到梗死面积的显著减少。

结论

本综述强调了干细胞疗法作为 AMI 患者有前途的治疗方法的潜力,提供了持续的 LVEF 改善和 MACE 风险降低的潜力。然而,需要进一步研究来优化细胞培养技术,确定最佳的时间和剂量,并研究程序变化,以最大限度地提高干细胞疗法在这种情况下的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93e4/11389242/2e51fe474995/13287_2024_3891_Fig1_HTML.jpg

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