骨髓干细胞移植改善心肌梗死患者左室重构的Meta分析

Meta analysis on therapeutic effect of bone marrow stem cell transplantation on left ventricular remodeling in patients with acute myocardial infarction

目的评价骨髓干细胞移植对心肌梗死患者左室重构的影响。方法根据纳入标准和剔除标准检索Medline、Embase、中国期刊全文数据库、Cochrane图书馆等电子数据库,收集国内外1966～2011年3月公开发表的关于急性心肌梗死后骨髓干细胞移植对左室重构的影响的随机对照研究的全文文献,最后纳入的文献用RevMan5.0进行分析。结果共纳入16项研究共894例患者。Meta分析结果显示:与对照组相比,自体骨髓干细胞移植显著降低了心肌梗死患者的左室舒张末期容积(WMD=-7.74;95%CI:-11.51～-3.37;P<0.01)和左室收缩末期容积(WMD=-8.22;95%CI:-13.62～-4.81;P<0.01)的变化。在亚组分析中,从3个月起即显示出减少左室重构的有益效应,并持续到6个月和12个月。结论骨髓干细胞移植可改善心肌梗死后的左心室重构。

Objective To review the influence of bone marrow stem cell transplantation on left ventricular remodeling in the patients with acute myocardial infarction（AMI）.Methods The full／｜text literature about the random and controlling studies on influence of bone marrow stem cell transplantation on left ventricular remodeling after AMI ventilated at home and abroad from 1966 to March 2011 were retrieved from Medline,Embase,China Journal Fulltext Database and Cochrane Library according to the inclusion and exclusion criteria.The literature was analyzed by using RevMan 5.0 software.Results There were totally 16 studies included（894 cases）.The results of Meta analysis showed that,compared with the control group,auto／｜transplantation of bone marrow stem cells decreased the left ventricular end／｜diastolic volume（WMD=-7.74;95% CI：-11.51^-3.37;P0.01） and left ventricular end／｜systolic volume（WMD=-8.22;95% CI：-13.62^-4.81;P0.01）.The analysis of subgroup showed the decrease of left ventricular remodeling began from the 3rd month and continued to the 6th month and 12th month.Conclusion The transplantation of bone marrow stem cells can ameliorate left ventricular remodeling after AMI.