间充质干细胞移植治疗失代偿期肝硬化的Meta分析

Mesenchymal stem cells transplantation for treating decompensated liver cirrhosis:a Meta-analysis

目的评价间充质干细胞移植对失代偿期肝硬化的临床疗效。方法计算机通过国内数据库及PubMed、Cochrane Library、EMBASE等数据库检索2017年11月前发表的关于干细胞移植治疗肝硬化的随机对照试验(RCT),依照纳入和排除标准筛选符合要求的文献。采用RevMan 5.3软件进行数据分析。结果本研究一共纳入8篇RCT文献,共394例肝硬化患者,其中MSCs试验组219例,对照组175例。与对照组相比,试验组移植前各项指标基线比较差异无统计学意义(P>0.05);MSCs移植治疗3个月后两组终末期肝脏疾病(MELD)评分(MD=-1.22,95%CI:-2.36～-0.08)、血清谷丙转氨酶(MD=-19.13,95%CI:-25.59～-9.27)比较差异有统计学意义(P<0.05);治疗6个月后两组MELD评分(MD=-1.38,95%CI:-2.19～-0.57)比较差异有统计学意义(P<0.05)。结论 MSCs移植治疗对于失代偿期肝硬化患者是有效的,可改善肝功能,降低病死率。

Objective To evaluate the therapeutic efficacy of mesenchymal stem cells(MSCs)transplatation on decompensanted liver cirrhosis.Methods The randomized controlled trials(RCTs)on the stem cells transplantation for treating liver cirrhosis were retrieved from the domestic databases and PubMed,Cochrane Library,EMBASE databases until November 2017 through computer.The literatures meeting the requirement were screened out according to the inclusion and exclusion criteria.Then the data were analyzed by using the RevMan 5.3 software.Results Eight RCTs were included,involving 394 cases of liver cirrhosis,among them 219 cases were in the MSCs treatment group,175 cases were in the control group.The baseline of various indexes before transplantation had no statistical difference between the treatment group and control group(P>0.05).There was a satistically significant difference between the end-stage liver disease(MELD)score(MD=-1.22,95%CI:-2.36 to-0.08)and ALT(MD=-19.13,95%CI:-25.59 to-9.27)after 3 months of MSCs transplantation of two groups(P<0.05);MELD score(MD=-1.38,95%CI:-2.19 to-0.57)also decreased after 6 months.Differences were significant between two groups(P<0.05).Conclusion MSCs transplantation treatment is effective for the patients with decompensated cirrhosis,improves the liver function and reduces the mortality rate.