脐带间充质干细胞移植治疗卵巢早衰有效性动物实验的Meta分析

Efficacy of umbilical cord mesenchymal stem cells transplantation in the treatment of premature ovarian failure:a meta-analysis of animal studies

目的系统评价脐带间充质干细胞移植治疗卵巢早衰的有效性。方法计算机检索CNKI、WanFang Data、SinoMed、PubMed和EMbase数据库,搜集关于脐带间充质干细胞移植治疗卵巢早衰的动物实验,检索时限均从建库起至2021年9月17日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进Meta分析。结果共纳入9个研究,包括302只小鼠。Meta分析结果显示:脐带间充质干细胞移植可使卵巢早衰鼠的始基卵泡[SMD=1.51,95%CI(0.80,2.22),P<0.0001]、初级卵泡[SMD=1.43,95%CI(0.76,2.09),P<0.0001]、次级卵泡[SMD=1.39,95%CI(0.78,2.01),P<0.00001]和窦状卵泡[SMD=1.15,95%CI(0.49,1.82),P=0.0007]数目显著增加;可显著升高卵巢早衰鼠的雌二醇浓度[SMD=2.38,95%CI(1.75,3.01),P<0.00001];可使血清促卵泡激素浓度[SMD=-1.98,95%CI(-2.80,-1.17),P<0.00001]下降。结论当前动物实验证据表明,脐带间充质干细胞移植可修复小鼠卵巢组织,改善卵巢内分泌功能。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objective To systematically review the efficacy of umbilical cord mesenchymal stem cells in the treatment of premature ovarian failure.Methods CNKI,WanFang Data,SinoMed,PubMed and EMbase databases were electronically searched to collect animal experiments of the efficacy of umbilical cord mesenchymal stem cells in the treatment of premature ovarian failure from inception to September 17th,2021.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies;then,meta-analysis was performed by using RevMan 5.4.1 software.Results A total of 9 studies involving 302 mice were included.The results of meta-analysis showed that:umbilical cord mesenchymal stem cell transplantation could increase primal follicles(SMD=1.51,95%CI 0.80to 2.22,P<0.0001),primary follicles(SMD=1.43,95%CI 0.76 to 2.09,P<0.0001),secondary follicles(SMD=1.39,95%CI0.78 to 2.01,P<0.00001)and sinus follicles(SMD=1.15,95%CI 0.49 to 1.82,P=0.0007).It significantly increased the concentration of estradiol in rats with premature ovarian failure(SMD=2.38,95%CI 1.75 to 3.01,P<0.00001),and decreased serum follicle-stimulating hormone concentration(SMD=-1.98,95%CI-2.80 to-1.17,P<0.00001).Conclusion Current evidence shows that umbilical cord mesenchymal stem cell transplantation can repair ovarian tissue and improve ovarian endocrine function in mice.Due to limited quality and quantity of the included studies,more high-quality studies are needed to verify above conclusions.