Liu Yulong, Xu Wenbo, Liu Guangchen, Ma Lingli, Li Zimeng
EFORT Open Rev. 2025 May 5;10(5):309-315. doi: 10.1530/EOR-2024-0142.
To investigate the efficacy of autologous bone marrow mesenchymal stem cell (BMSC) transplantation in patients with spinal cord injury (SCI) using meta-analysis, aiming to provide evidence-based guidance for clinical practice.
Electronic databases such as PubMed, Web of Science, Cochrane Library and Embase were searched. Studies comparing the therapeutic effects of autologous BMSC transplantation and rehabilitation therapy on patients with SCI were included. The pooled effect size of autologous BMSC transplantation on the American Spinal Injury Association (ASIA) scores was calculated using the random- or fixed-effects model.
A total of seven eligible studies involving 288 patients with SCI were included in this study. The meta-analysis results showed that autologous BMSC transplantation significantly improved ASIA sensory scores (mean difference (MD): 8.80; 95% confidence interval (CI): 5.93, 11.67), ASIA motor scores (MD: 7.94; 95% CI: 2.05, 13.83), ASIA grade improvement (odds ratio (OR): 4.88; 95% CI: 2.48, 9.61) and somatosensory evoked potential improvement (OR: 3.34; 95% CI: 1.54, 7.25). This study did not find a statistically significant positive effect of autologous BMSC transplantation on bladder function and adverse events.
The therapeutic efficacy of autologous BMSC transplantation is encouraging, but further multicentre, large-sample, prospective studies are still needed.
采用荟萃分析方法探讨自体骨髓间充质干细胞(BMSC)移植治疗脊髓损伤(SCI)患者的疗效,旨在为临床实践提供循证指导。
检索PubMed、Web of Science、Cochrane图书馆和Embase等电子数据库。纳入比较自体BMSC移植与康复治疗对SCI患者治疗效果的研究。采用随机效应模型或固定效应模型计算自体BMSC移植对美国脊髓损伤协会(ASIA)评分的合并效应量。
本研究共纳入7项符合条件的研究,涉及288例SCI患者。荟萃分析结果显示,自体BMSC移植显著改善了ASIA感觉评分(平均差(MD):8.80;95%置信区间(CI):5.93,11.67)、ASIA运动评分(MD:7.94;95%CI:2.05,13.83)、ASIA分级改善(优势比(OR):4.88;95%CI:2.48,9.61)和体感诱发电位改善(OR:3.34;95%CI:1.54,7.25)。本研究未发现自体BMSC移植对膀胱功能和不良事件有统计学意义的积极影响。
自体BMSC移植的治疗效果令人鼓舞,但仍需要进一步开展多中心、大样本的前瞻性研究。