【摘要】：背景:自體骨髓間充質(zhì)干細胞已被用于擴張性心肌病的臨床治療,但其安全性和有效性存在爭議。目的:運用Meta分析方法評價自體骨髓間充質(zhì)干細胞移植治療擴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、萬方數(shù)據(jù)庫中,有關自體骨髓間充質(zhì)干細胞移植與常規(guī)藥物治療擴張性心肌病的臨床隨機對照試驗。運用R3.1.0軟件對兩種治療后的左室射血分數(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、治療及隨訪過程中患者死亡率、惡性心律失常發(fā)生率及心臟移植率進行Meta分析。結果與結論:納入7個隨機對照試驗,合計341例擴張性心肌病患者。Meta分析結果顯示:與常規(guī)藥物療法相比,自體骨髓間充質(zhì)干細胞移植能增加擴張性心肌病患者左心室射血分數(shù)[1個月:MD=3.02,95%CI(1.55,4.49);3個月:MD=4.38,95%CI(3.55,5.52);6個月:MD=6.47,95%CI(4.78,8.15);≥12個月:MD=8.23,95%CI(5.15,9.19)],降低治療3個月后的左室舒張末期內(nèi)徑[3個月:MD=-0.65,95%CI(-0.72,-0.59);6個月:MD=-0.12,95%CI(-0.21,-0.03);≥12個月:MD=-0.19,95%CI(-0.24,-0.13)],增加治療6個月后6 min步行距離[6個月:MD=87.70,95%CI(51.55,123.85);≥12個月:MD=143.83,95%CI(122.73,164.93)],降低治療3個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明顯差異。研究結果提示,自體骨髓間充質(zhì)干細胞移植治療擴張性心肌病療效優(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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