细胞种植支架用于尿道重建动物实验的Meta分析

Cell seeding engineering material for urethral reconstruction:a Meta-analysis of animal experiments

目的系统性回顾了已发表的组织工程修复尿道的动物实验,分析动物实验的成功因素,总结其有效性及未来在临床应用中的可行性。方法文中收集了Pubmed、Embase、Biosis Previews与CNKI数据库1980—2014年的文章。所有的数据用Review Manager 5软件及STATA12.0软件进行Meta分析。结果 16项临床前期动物实验被纳入到我们的Meta分析中。细胞种植支架与脱细胞支架用于尿道重建的效果有明显差异(Z=4.7,P<0.000 01;RR=5.25,95%CI=2.60~11.20)。种植2种细胞与种植1种细胞无明显差异(Z=0.75,P=0.45),但病理提示种植2种细胞可产生更多的细胞层,形成毛细血管。上皮分化干细胞种植支架的手术效果明显优于未分化干细胞种植支架。结论运用种植细胞的生物支架制作尿道替代材料是可靠的。上皮细胞、平滑肌细胞或成纤维细胞均适于种植。干细胞,特别是上皮分化的干细胞可能成为未来的研究方向。

Objective To evaluate the possibility and reconstruction by systematically reviewing published studies feasibility of cell-seeding tissue engineering approach for urethral Methods Preclinical studies of tissue engineering approaches for urethral reconstruction published during 1980 and 2014 were systematically searched in databases including PubMed, Embase, and Biosis Previews and CNKI. Data extracted were analyzed with Review Manager 5 and STATA12.0 software. Results A total of 16 animal studies were included in our meta-analysis. There were significant differences between cell seeding scaffold and acellular scaffold （Z=4.7, P^0.000 01,RR=5.25, 95%CI=2.60-11.20）. Seeding two types of cells had the same success rate as seeding one type of cell （Z = 0.75, P= 0.45）, but pathological. Results indicated that seeding two types of cells could form more layers of cells and capillaries. Epithelial differentiation of stem cells was better than that of undifferentiated stem ceils. Conclusion Cell-seeding biomaterial used in creating a nee-urethra is stable and effective. Epithelial cells, smooth muscle cells and fibroblasts are suitable for seeding. Stem cells, especially those after epithelial differentiation, can be a promising choice for future researches.