嗅鞘细胞移植对大鼠脊髓损伤运动功能恢复影响的系统评价

Effect of Olfactory Ensheathing Cells Transplantation for Motor Function Restitution on Spinal Cord Injury of Rats: A Systematic Review

目的系统评价嗅鞘细胞(OECs)移植对脊髓损伤功能恢复的影响。方法计算机检索CBM、CNKI、VIP和PubMed中关于嗅鞘细胞移植治疗大鼠脊髓损伤的随机对照实验。各数据库的检索时间均为1989年1月至2009年12月。以Jadad量表评价纳入研究质量,提取有效数据,采用RevMan4.2软件进行Meta分析。结果纳入12篇随机对照实验,共237只大鼠,纳入研究质量较低。OECs组后肢运动功能(BBB)评分高于对照组,其差异有统计学意义[WMD=1.67,95%CI(0.99,2.36);WMD=3.61,95%CI(1.97,5.26);WMD=6.50,95%CI(5.76,7.24);WMD=4.23,95%CI(1.19,7.28);WMD=1.90,95%CI(1.22,2.58);WMD=3.30,95%CI(2.63,3.97)];电生理检测运动诱发电位(MEP)高于对照组,其差异有统计学意义[WMD=–3.98,95%CI(–5.71,–2.25)];感觉诱发电位(SEP)及波幅变化两组差异均无统计学意义[WMD=–7.13,95%CI(–16.49,2.23);WMD=3.00,95%CI(–1.12,7.11);WMD=1.95,95%CI(–0.89,4.78)]。结论基于目前实验性证据,嗅鞘细胞移植对脊髓损伤的功能恢复有促进作用,但对运动电生理学变化无明显影响。

Objective To review evidences of the relationship between olfactory ensheathing cells （OECs） transplantation and motor functional restitution of spinal cord injury （SCI）. Methods We searched the CBM, CNKI, VIP and PubMed databases for collecting relative studies published from January 1989 to December 2009. Randomized controlled experiments of treating rats SCI with OECs transplantation were included. Quality of included experiments was assessed by Jadad scale, and the available data were abstracted and meta-analyzed with RevMan 4.2 software. Results A total of 12 randomized controlled experiments were identiffed. Meta-analysis showed that, OECs group was higher than control group in both BBB score （WMD=1.67, 95%CI 0.99 to 2.36; WMD=3.61, 95%CI 1.97 to 5.26; WMD=6.50, 95%CI 5.76 to 7.24; WMD=4.23, 95%CI 1.19 to 7.28; WMD=1.90, 95%CI 1.22 to 2.58; WMD=3.30, 95%CI 2.63 to 3.97） and MEP latency period （WMD= – 3.98, 95%CI – 5.71 to – 2.25）, but there was no statistical significance in SEP latency period or amplitude period （WMD= – 7.13, 95%CI – 16.49 to 2.23; WMD=3.00, 95%CI – 1.12 to 7.11; WMD=1.95, 95%CI – 0.89 to4.78）. Conclusions This meta-analysis based on current experiments suggests that OECs transplantation is superior in motor function restitution after spinal cord injury, but is similar as control group in SEP latency or amplitude.