脂肪来源干细胞治疗糖尿病足溃疡的潜力：一项系统评价和荟萃分析。
Therapeutic potential of adipose-derived stem cells for diabetic foot ulcers: a systematic review and meta-analysis.
作者信息
Elainein Mohamed A Abu, Whdan Mohamad Mahmoud, Samir Mahmoud, Hamam Nada G, Mansour Mohamed, Mohamed Mohamed Abdel Mohsen, Snosy Mahmoud Mostafa, Othman Mahmoud Ayman, Sobieh Ahmed Sayed, Saad Mahmoud Gamal, Labna Mohamed A, Allam Salma
机构信息
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Faculty of Medicine, Cairo University, Cairo, Egypt.
出版信息
Diabetol Metab Syndr. 2025 Jan 7;17(1):9. doi: 10.1186/s13098-024-01523-5.
BACKGROUND
As the global prevalence of diabetes mellitus increases, the incidence of non-healing wounds in diabetic patients is expected to rise significantly, according to the International Diabetes Federation (IDF), around 537 million adults currently suffer from diabetes mellitus worldwide and 20% to 30% of individuals with diabetes are hospitalized due to diabetic foot ulcers. Conventional treatments such as traditional dressings often fall short in ensuring satisfactory wound healing, this Meta-analysis investigates the therapeutic potential of Adipose-derived Stem Cells (ADSCs) as a promising strategy for addressing this challenge.
AIMS
To Assess the Therapeutic Potential of Adipose-Derived Stem Cells for Managing Diabetic Foot Ulcers compared to conventional lines of treatments.
METHODS
The PubMed, SCOPUS, Web of Science Core Collection, Cochrane Library, and ClinicalTrials.gov. databases were searched from January 2000 and December 2023, articles were primarily evaluated regarding their titles and abstracts, then full-text screening was assessed against the inclusion and exclusion criteria by utilizing Rayyan software. The Cochrane risk of bias (RoB 2) assessment tool was used to identify the risk of bias in our included studies. A statistical analysis was performed using Review Manager (RevMan) Version 5 software. Dichotomous data was subjected to risk ratio analysis, while continuous data underwent Mean Difference (MD) evaluation, all was reported with 95% confidence intervals, P value is considered statistically significant if less than 0.05.
RESULTS
Regarding the total healing state, five studies reported that more participants healed completely at the end of the follow-up period in the ADSCs group (Risk ratio = 1.56, 95% CI [1.32, 1.86], P < 0.00001), for the healing rate the overall effect estimate favors the ADSCs group (pooled effect estimate = 1.84, 95% CI [1.51, 2.89], P < 0.00001), and regarding the healing time the pooled mean difference of the studies demonstrated that the ADSCs group required fewer days to heal than the standard care group. (pooled mean difference = -19.33, 95% CI [-37.36, -1.29], P = 0.04).
CONCLUSION
ADSCs provide favorable healing results and safety compared to standard care for diabetic foot ulcers.
背景
随着全球糖尿病患病率的增加，据国际糖尿病联合会（IDF）称，糖尿病患者中难愈合伤口的发生率预计将显著上升。目前全球约有5.37亿成年人患有糖尿病，20%至30%的糖尿病患者因糖尿病足溃疡住院。传统敷料等常规治疗方法在确保伤口满意愈合方面往往效果不佳，本荟萃分析研究了脂肪干细胞（ADSCs）作为应对这一挑战的一种有前景策略的治疗潜力。
目的
评估与传统治疗方法相比，脂肪干细胞治疗糖尿病足溃疡的治疗潜力。
方法
检索了2000年1月至2023年12月期间的PubMed、SCOPUS、科学引文索引核心合集、Cochrane图书馆和ClinicalTrials.gov数据库。文章首先根据标题和摘要进行初步评估，然后使用Rayyan软件根据纳入和排除标准进行全文筛选。使用Cochrane偏倚风险（RoB 2）评估工具来识别纳入研究中的偏倚风险。使用Review Manager（RevMan）5版软件进行统计分析。二分数据进行风险比分析，连续数据进行平均差（MD）评估，所有结果均报告95%置信区间，如果P值小于0.05则被认为具有统计学意义。
结果
关于总体愈合状态，五项研究报告称，在随访期结束时，ADSCs组有更多参与者完全愈合（风险比=1.56，95%置信区间[1.32，1.86]，P<0.00001）；对于愈合率，总体效应估计有利于ADSCs组（合并效应估计=1.84，95%置信区间[1.51，2.89]，P<0.00001）；关于愈合时间，研究的合并平均差表明，ADSCs组愈合所需天数比标准护理组少（合并平均差=-19.33，95%置信区间[-37.36，-1.29]，P=0.04）。
结论
与糖尿病足溃疡的标准护理相比，ADSCs提供了良好的愈合效果和安全性。
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