摘要
目的 系统评价干细胞移植对失代偿期肝硬化的治疗作用.方法 计算机检索中国期刊全文数据库、万方数据库、中国生物医学文献数据库、CALLS学位论文库和Pubmed、Embase、Cochrane Library和Google学术数据库,收集应用干细胞移植治疗失代偿期肝硬化的随机对照临床试验（RCT）,辅以手工检索,评价文献质量,合并肝功能结果进行Meta分析.结果 纳入研究的29篇文献均为RCT,共1 161例患者.Meta分析结果显示,术前移植组和对照组患者各指标差异无统计学意义;移植组术后第4、8、12周患者丙氨酸氨基转移酶（ALT）[MD4周=-17.17,95％CI（-24.90,-9.43）,P＜0.001]、[MD蜩=-14.80,95％CI（-22.32,-7.28）,P＜0.001]、[MD12周=-15.5,95％ CI（-28.47,-2.52）,P＜0.001]、血浆总胆红素（T-Bil）[MD4周=-5.92,95％CI（-9.72,-2.13）,P＜0.001]、[MD8周 =-12.02,95％CI（-18.78,-5.25）,P＜0.001]、[MD12周=-11.23,95％CI（-19.61,-2.84）,P＜0.001]水平均明显低于对照组;而血清白蛋白（ALB）[MD4周=2.87,95％CI（1.83,3.92）,P＜0.001]、[MD8周=5.11,95％ CI（3.90,6.31）,P＜0.001]、[MD12周=4.66,95％ CI（2.10,7.22）,P＜0.001]、凝血酶原活动度（PTA）[MD4周=3.76,95％CI（-0.98,8.49）,P＜0.001]、[MD8周=7.92,95％CI（4.25,11.58）,P＜0.001]、[MD12周=10.51,95％CI（-2.15,23.17）,P＜0.001]均明显较对照组升高.结论 干细胞移植能改善失代偿期肝硬化,干细胞治疗的发展需要更多的注册临床研究.
Objective To evaluate the effect of stem cells transplantation on liver function in patients with decompensated liver cirrhosis. Methods Randomized controlled trials （RCTs） about effect of stem ceils transplan- tation on liver function in patients with decompensated liver cirrhosis were retrieved from CNKI, Wanfang database, CBMdisc, CALIS thesis database, Pubmed, Embase, Cochrane Library and Google academic online database and screened. Quality evaluation and Meta-analysis of included literatures were conducted. Results A total of 29 RCTs involving 1 161 patients were collected. Meta-analysis results showed that the baselines of main observational index in treatment group and control group were undifferentiated. However, 4, 8, 12 weeks after transplantation, the levels of alanine aminotransferase （ALT） [MD4weeks=-17.17, 95%CI （-24.90,-9.43）, P〈0.001], [MDsweeks=-14.80, 95%CI （-22.32,-7.28）, P〈0.001], [MD12weeks=-15.5, 95%CI（-28.47,-2.52）, P〈0.001] and total bilirubin （T-Bil） [MD4weeks= -5.92, 95%CI （-9.72,-2.13）, P〈0.001], [MD8weeks=-12.02, 95%CI（-18.78,-5.25）, P〈0.001], [MD12weeks=-11.23, 95% CI （-19.61,-2.84）, P〈0.001] in treatment group were significantly lower than that in control group. And the levels of albumin （ALB） [MD4weeks=2.87, 95% CI （1.83, 3.92）, P〈0.001], [MD8weeks= 5.11, 95% CI （3.90, 6.31）, P〈0.001], [MD12weeks= 4.66, 95%CI （2.10, 7.22）, P〈0.001] and prothrombin activity （PTA） [MD4weeks= 3.76, 95%CI （-0.98, 8.49）, P〈0.001], [MD8w= 7.92, 95%CI （4.25, 11.58）, P〈0.001], [MD12weeks=10.51, 95%CI （-2.15, 23.17）, P〈0.001] in treatment group were significantly higher than control. Conclusions Liver function in patients with deeompensated liver cirrhosis can be significantly improved by transplantation of stem cells, and more registered clinical trials are necessary for the potential development of stem cells treatment technology.
出处
《国际生物医学工程杂志》
CAS
2014年第6期341-346,共6页
International Journal of Biomedical Engineering
基金
湖北省自然科学基金资助项目（2011CDB488）
关键词
干细胞
移植
肝硬化
肝衰竭
META分析
Stem cells
Transplantation
Liver cirrhosis
Liver failure
Meta-analysis
