骨髓间充质干细胞治疗缺血性中风的安全性和有效性:元分析

Feng Zhang, Yanyan Wang
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引用次数: 0

摘要

我们旨在系统评估骨髓间充质干细胞(BMMSCs)治疗缺血性脑卒中的有效性和安全性。 我们在六个中英文数据库中检索了自数据库建立至 2023 年 2 月 28 日期间的相关随机对照试验。两位研究者对研究进行了筛选和综合分析,并对研究质量进行了评估。他们从纳入的研究中提取信息,并使用 RevMan 5.4.1 软件(中国三峡大学第一临床医学院)对数据进行管理和分析。最后,他们进行了元分析和异质性分析,并绘制了偏倚风险图。 共纳入 13 篇高质量文章。实验组与对照组在治疗后3个月(I 2 50%,MD = 15.94,P < 0.001)、3个月(I 2 >50%,MD = 12.71,P < 0.001)和6个月(I 2 >50%,MD = 13.76,P < 0.001)的美国国立卫生研究院卒中量表(NIHSS)评分差异显著,总体差异(I 2 >50%,MD = 14.38,P ≤ 0.001)显著。功能独立性测量(FIM)评分在1个月(I 2 >50%,MD = 20.04,P = 0.02)、3个月(I 2 >50%,MD = 15.51,P < 0.001)和6个月(I 2 >50%,MD = 13.46,P = 0.03)时与对照组相比均有显著差异。与传统治疗方案相比,不良反应没有明显增加。 在一定程度上,BMMSC 移植可以改善缺血性脑卒中患者的神经功能缺损、运动功能和日常生活能力。
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Safety and Efficacy of Bone Marrow Mesenchymal Stem Cells in the Treatment of Ischemic Stroke: A Meta-Analysis
We aimed to systematically evaluate the efficacy and safety of bone marrow mesenchymal stem cells (BMMSCs) in the treatment of ischemic stroke. Six Chinese and English databases were searched for related randomized controlled trials from the establishment of the databases to 28 February 2023. Two investigators performed screening and a comprehensive analysis and evaluated the quality of the studies. They extracted information from the included studies, and managed and analzsed the data using RevMan 5.4.1 software (The First College of Clinical Medical Science, China Three Gorges University). Finally, they performed meta and heterogeneity analyses and created a risk-of-bias map. A total of 13 high-quality articles were included. The National Institute of Health Stroke Scale (NIHSS) scores of the experimental group differed significantly from those of the control group at 3 months (I 2 <50%, mean difference [MD] = −2.88, P < 0.001) after treatment. The Fugl–Meyer assessment (FMA) scores of the experimental group varied significantly from that of the control group at 1 month (I 2 >50%, MD = 15.94, P < 0.001), 3 months (I 2 >50%, MD = 12.71, P < 0.001), and 6 months (I 2 >50%, MD = 13.76, P < 0.001) after treatment, and the overall difference (I 2 >50%, MD = 14.38, P ≤ 0.001) was significant. The functional independence measure (FIM) scores were significantly different from that of the control group at 1 month (I 2 >50%, MD = 20.04, P = 0.02), 3 months (I 2 >50%, MD = 15.51, P < 0.001), and 6 months (I 2 >50%, MD = 13.46, P = 0.03). There was no significant increase in adverse events compared with the traditional treatment regimen. To some extent, BMMSC transplantation can improve the neurological deficit, motor function, and daily living ability of patients with ischemic stroke.
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