干细胞移植治疗复杂性肛瘘疗效的Meta分析

Stem cell transplantation in treatment of complex anal fistula: a meta-analysis

目的系统评价干细胞移植治疗复杂性肛瘘的疗效。方法系统检索Pub Med、EMBASE及Cochrane图书馆等网络数据库2017年8月前发表的、关于干细胞移植治疗复杂性肛瘘疗效评价的随机对照研究(RCT),手工检索相关专业期刊以追溯相关参考文献;文献检索及筛选、数据提取和文献偏倚评估均由2位研究者独立交叉进行。应用Stata 13.0软件对肛瘘愈合率进行统计分析。结果共纳入4篇RCT的465例患者,其中试验组(干细胞移植)270例,对照组(安慰剂)195例。Meta分析结果显示,试验组患者术后第6~8周以及第12、24周的肛瘘愈合率均较对照组明显升高(RR_(第6~8周)=4.66,95%CI:1.54~14.08;RR_(第12周)=2.48,95%CI:1.53~4.04;RR_(第24周)=1.22,95%CI:0.97~1.53)。结论干细胞移植能明显提高复杂性肛瘘的治愈率,是一种治疗肛瘘的有效手段。

Objective To evaluate the efficacy of stem cell transplantation in treatment of complex anal fistula. Methods Randomized controlled trials(RCTs) of stem cell transplantation for anal fistula were electronically searched in databases of Pub Med, EMBASE and Cochrane Library up to August 2017, and manual search for relevant studies was also conducted. The literature search, screening, data extraction and literature bias assessment were conducted by two authors independently. The anal fistula healing rate was meta-analyzed using Stata13.0 software. Results Four RCTs were included in the analysis involving 465 patients, among whom 270 received stem cell transplantation(study group) and 195 received placebo(control group). Meta-analysis showed that compared with control group, the healing rates of anal fistula in study group were significantly higher at 6-8 weeks, 12 weeks and 24 weeks after treatment(RR=4.66, 95% CI: 1.54~14.08; RR=2.48, 95%CI: 1.53~4.04; RR=1.22, 95%CI: 0.97~1.53,respectively). Conclusion Stem cell transplantation can significantly improve the healing rate of complex anal fistula.