干细胞局部应用对缺损面神经再生效果的系统评价

Effect of the local application of stem cells on repairing facial nerve defects: a systematic review

目的系统评价干细胞对面神经缺损的修复效果。方法在Pubmed、Cochrane Library、Web of Science、Embase、Scopus及中国生物医学文献数据库检索关于评价干细胞对动物面神经再生效果的所有原始研究,2名专业人员独立完成文献筛选、数据提取及偏倚风险评估。使用RevMan 5.3软件及随机效应模型进行统计分析,分析结果以均数差(MD)及95%可信区间(CI)的形式呈现。对面神经的功能性评估(胡须运动评分、面瘫评分)及组织学评估(有髓纤维密度、纤维直径、髓鞘厚度、G比值)结果进行Meta分析。结果从6个数据库共检索出4614篇文献,15篇被纳入了Meta分析。干细胞组的胡须运动评分、面瘫评分、有髓纤维密度、髓鞘厚度均高于非干细胞组(P<0.05),G比值小于非干细胞组(P=0.001),纤维直径二者无统计学差异(P=0.08)。结论干细胞具有促进面神经再生的潜能。

Objective To systematically evaluate the repairing effect of stem cells on facial nerve defects.Methods Articles regarding the regenerating effect of stem cells on facial nerves in animals were collected from the databases of Pubmed,Cochrane Library,Web of Science,Embase,Scopus,and CBM.Two professionals independently completed the article screening,data extraction,and bias risk assessment.RevMan 5.3 and random-effects models were used for the statistical analysis,and the results were presented in the form of mean differences(MD)with a 95%CI.The results of functional evaluation(vibrissae movement,facial paralysis)and histological evaluation(density of myelinated fibers,diameter of fibers,thickness of myelin sheath,G ratio)of facial nerve were Meta-analyzed.Results A total of 4614 articles were retrieved from the 6 databases,and 15 of these articles were included in the Meta-analysis.For vibrissae movement and facial paralysis,the stem cell group scored significantly higher than the non-stem cell group(P<0.05).The density of myelinated fibers and thickness of the myelin sheath in the stem cell group were higher than those in the non-stem cell group(P<0.05).The G ratio in the stem cell group was smaller than that in the non-stem cell group(P=0.001).There was no significant difference in fiber diameter(P=0.08).Conclusion Stem cells have potential in promoting facial nerve regeneration.