经冠状动脉自体骨髓干细胞移植对急性心肌梗死后左室射血分数影响的荟萃分析

A meta-analysis of left ventricular ejection fraction after intracoronary autologous bone marrow stem cells transfer for patients with acute myocardial infarction

目的:荟萃(meta)分析经冠状动脉自体骨髓干细胞移植对急性心肌梗死(AMI)后(6个月)左室射血分数的影响。方法:通过PubMed检索1990-2012年完成的经冠状动脉自体骨髓干细胞治疗AMI的随机对照研究,利用meta分析对研究结果进行评价。结果:通过检索得到11篇文献。与对照组相比,自体骨髓干细胞治疗增加左室射血分数3.04%,95%可信区间为-0.22%～6.31%,P=0.07。有7项研究的基础左室射血分数<50%,meta分析显示,与对照组相比,干细胞治疗可以显著增加AMI后(6个月)的左室射血分数,平均增加4.12%,95%的可信区间为0.14%～8.10%,P=0.04。4项前壁AMI研究的亚组分析显示,与对照组相比,干细胞治疗增加左室射血分数2.35%,95%的可信区间为-1.49%～6.19%,P=0.23,均差异无统计学意义。结论:经冠状动脉自体骨髓干细胞移植对基础左室射血分数<50%的患者AMI后(6个月)的左室射血分数有改善作用。

Objective：Using meta-analysis method to study the left ventricular ejection fraction（LVEF）in acute myocardial infarction（AMI）after 6months following with intracoronary autologous bone marrow stem cells transfer.Method：We used PubMed retrieval the CRT of intracoronary autologous bone marrow stem cells transfer for patients with AMI from 1990s to 2012s.Then we used meta-analysis method to study the LVEF at 6months.Result：There are eleven trials available for this study.Meta-analysis showed that the LVEF increased 3.04%compared to control（95%CI：-0.22%-6.31%;P=0.07）.In subgroup analysis,there were seven trials associate with baseline LVEF less than 50%,and the LVEF at 6months after AMI increased 4.12% compare to control（95%CI：0.14%-8.10%;P=0.04）.Four trials associate with acute anterior myocardial infarction had no significant on LVEF between two groups（95%CI：-1.49%-6.19%;P=0.23）.Conclusion：Intracoronary autologous bone marrow stem cells transfer can increased LVEF at 6month significantly in patients with AMI with baseline LVEF less than 50%.