【作者】 邢冬梅； 王永霞； 李彬； 彭广操； 吴泰相； 朱明军；

【机构】 河南中医学院第一附属医院； 中国循证医学中心； 华西医学院；

【摘要】 目的系统评价干细胞移植治疗原发性扩张型心肌病的临床疗效和安全性。方法检索中国生物医学文献光盘数据库、CNKI数据库、维普数据库、万方数据库、Cochrane图书馆临床对照试验数据库、OVID medline和EMBASE。由2名研究人员独立阅读并交叉核对纳入研究及其资料。主要疗效指标为病死率和心衰量表;次要疗效指标为左室射血分数、左室舒张末期内径和六分钟步行距离。安全性指标为不良反应事件发生率。采用Cochrane协作网提供的RevMan 5.0.2软件进行Meta分析。结果 7个RCT,共包括267名患者,Meta分析结果:细胞移植联合常规药物治疗的3年病死率与单用常规药物治疗相比无差别;细胞移植联合常规药物治疗在提高术后3个月左室射血分数方面并不优于单用常规药物治疗;与细胞移植有关的不良反应尚未发现。结论细胞移植联合常规药物治疗并不优于单用常规药物治疗,然而,由于纳入的RCT数量较少,质量较低,因此还有待于更多大规模高质量的研究以进一步论证。更多还原

【Abstract】 Objective to assess systematically the safety and effects of stem cell transplantation in dilated cardiomyopathy patients.Method CBM,CNKI,VIP,CENTRAL, OVID MEDLINE and EMBASE were searched for RCT of the use of stem cell transplantation for dilated cardiomyopathy.The primary endpoints are mortality and quality of life;the secondary outcomes are ejection of left ventricular,left ventricular end distolic diameter,6 minute walking test;safety outcomes are the incidence of adverse events.We assessed the effects by doing meta-analysis with The Cochrane Collaboration’s Review Manager.Result seven RCTs were included involving a total of 263 participants.Meta analysis showed that stem cell transplantation combined with standard therapy is not better than single standard drug therapy in improving 3-year mortality and left ventricular ejection.And cell transplantation related adverse events have not been identified.Conclusion The current evidence is insufficient to determine whether or not stem cell transplantation is a safe and effective therapy for dilated cardiomyopathy patients.Large scale,high quality,randomized trials are needed to assess the role of stem cell transplantation for dilated cardiomyopathy.更多还原