【摘要】：背景:自體骨髓間充質(zhì)干細(xì)胞已被用于擴(kuò)張性心肌病的臨床治療,但其安全性和有效性存在爭(zhēng)議。目的:運(yùn)用Meta分析方法評(píng)價(jià)自體骨髓間充質(zhì)干細(xì)胞移植治療擴(kuò)張性心肌病的安全性和有效性。方法:系統(tǒng)檢索Pub Med、Cochrane Library(2016年第2期)、Embase、CNKI、CBM、維普、萬(wàn)方數(shù)據(jù)庫(kù)中,有關(guān)自體骨髓間充質(zhì)干細(xì)胞移植與常規(guī)藥物治療擴(kuò)張性心肌病的臨床隨機(jī)對(duì)照試驗(yàn)。運(yùn)用R3.1.0軟件對(duì)兩種治療后的左室射血分?jǐn)?shù)、左室舒張末期內(nèi)徑、6 min步行距離、心肌灌注缺損面積百分比、治療及隨訪過(guò)程中患者死亡率、惡性心律失常發(fā)生率及心臟移植率進(jìn)行Meta分析。結(jié)果與結(jié)論:納入7個(gè)隨機(jī)對(duì)照試驗(yàn),合計(jì)341例擴(kuò)張性心肌病患者。Meta分析結(jié)果顯示:與常規(guī)藥物療法相比,自體骨髓間充質(zhì)干細(xì)胞移植能增加擴(kuò)張性心肌病患者左心室射血分?jǐn)?shù)[1個(gè)月:MD=3.02,95%CI(1.55,4.49);3個(gè)月:MD=4.38,95%CI(3.55,5.52);6個(gè)月:MD=6.47,95%CI(4.78,8.15);≥12個(gè)月:MD=8.23,95%CI(5.15,9.19)],降低治療3個(gè)月后的左室舒張末期內(nèi)徑[3個(gè)月:MD=-0.65,95%CI(-0.72,-0.59);6個(gè)月:MD=-0.12,95%CI(-0.21,-0.03);≥12個(gè)月:MD=-0.19,95%CI(-0.24,-0.13)],增加治療6個(gè)月后6 min步行距離[6個(gè)月:MD=87.70,95%CI(51.55,123.85);≥12個(gè)月:MD=143.83,95%CI(122.73,164.93)],降低治療3個(gè)月的心肌灌注缺血面積百分比[MD=-3.56,95%CI(-5.57,-1.55)],降低治療及隨訪期間死亡率[RR=0.46,95%CI(0.24,0.89)];兩種治療在降低惡性心律失常及心臟移植率上無(wú)明顯差異。研究結(jié)果提示,自體骨髓間充質(zhì)干細(xì)胞移植治療擴(kuò)張性心肌病療效優(yōu)于常規(guī)藥物療法,且安全性良好。
[Abstract]:Background: autologous bone marrow mesenchymal stem cells have been used in the treatment of dilated cardiomyopathy, but their safety and efficacy are controversial. Objective: to evaluate the safety and efficacy of autologous bone marrow mesenchymal stem cell transplantation in the treatment of dilated cardiomyopathy by Meta analysis. Methods: the clinical randomized controlled trials of autologous bone marrow mesenchymal stem cell transplantation and routine drug therapy for dilated cardiomyopathy were systematically searched in Pub Meda Cochrane Library (second issue 2016). The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVED) walking distance of 6 min, the percentage of myocardial perfusion defect area and mortality during treatment and follow-up were measured by R3.1.0 software. The incidence of malignant arrhythmia and the rate of cardiac transplantation were analyzed by Meta. Results and conclusion: a total of 341 patients with dilated cardiomyopathy were enrolled in 7 randomized controlled trials. 鑷綋楠ㄩ珦闂村厖璐ㄥ共緇嗚優(yōu)縐繪鑳藉鍔犳墿寮犳，

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