干细胞移植治疗缺血性脑卒中患者临床疗效的Meta分析
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摘要
目的对干细胞移植治疗脑卒中患者的临床疗效和安全性进行Meta分析。方法计算机检索PubMed、EMbase、Cochrane Library、维普数据库、万方数据库及CNKI数据库有关干细胞移植治疗脑卒中患者的随机对照试验,检索时间为建库至2018年12月。经过两名系统评价员根据文献纳入与排除标准筛选文献,并提取资料中的相关重要信息,评价纳入文献的偏倚风险后,采用Stata 11.0软件进行纳入文献的Meta分析以及森林图的解析,同时绘制漏斗图及进行纳入文献的敏感性分析。结果通过系统筛选共纳入29篇临床研究,总计1 908例脑卒中患者。干细胞移植治疗脑卒中患者神经功能缺损评分(NIHSS)、日常生活能力评定Barthel指数(BI)、肢体运动功能评分(FMA)和功能独立性评定量表(FIM)合并后的结果均优于对照组,2组间效应量差异有统计学意义。结论干细胞移植治疗脑卒中能有效改善患者的神经功能缺损,提高患者自主行为能力和肢体运动功能。
ObjectiveTo evaluate systematically the clinical efficacy and safety of stem cell therapies for patients with ischemic stroke.MethodsPubMed, EMbase, the Cochrane Library, VIP database, Wanfang database and CNKI database were searched by computer about randomized controlled trials of stem cell therapies for patients with ischemic stroke. The retrieval time was from the set up of library to December 2018. Two systematic evaluators screened the literatures according to inclusion and exclusion standards, and extracted the important information of literature. After assessing the quality of included studies, the risk of bias was analyzed by Stata 11.0 software for systematic evaluation and forest plot analysis, and obtained the funnel plot and the sensitivity analysis of included studies.ResultsA total of 29 case-control studies including total of 1 908 ischemic stroke patients were included in the systematic screening. The results of Meta analysis showed that the neural function deficient degree score(NIHSS), Barthel index(BI), Fugl-Meyer assessment(FMA) and the functional independence measure(FIM) are significantly better in stroke patients with treatment of stem cell transplantation than those of patients in control group.ConclusionStem cell transplantation can improve effectively the neurological deficit, autonomous behavior ability and body movement function of patients with ischemic stroke.
ObjectiveTo evaluate systematically the clinical efficacy and safety of stem cell therapies for patients with ischemic stroke.MethodsPubMed, EMbase, the Cochrane Library, VIP database, Wanfang database and CNKI database were searched by computer about randomized controlled trials of stem cell therapies for patients with ischemic stroke. The retrieval time was from the set up of library to December 2018. Two systematic evaluators screened the literatures according to inclusion and exclusion standards, and extracted the important information of literature. After assessing the quality of included studies, the risk of bias was analyzed by Stata 11.0 software for systematic evaluation and forest plot analysis, and obtained the funnel plot and the sensitivity analysis of included studies.ResultsA total of 29 case-control studies including total of 1 908 ischemic stroke patients were included in the systematic screening. The results of Meta analysis showed that the neural function deficient degree score(NIHSS), Barthel index(BI), Fugl-Meyer assessment(FMA) and the functional independence measure(FIM) are significantly better in stroke patients with treatment of stem cell transplantation than those of patients in control group.ConclusionStem cell transplantation can improve effectively the neurological deficit, autonomous behavior ability and body movement function of patients with ischemic stroke.
引文
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[3]安泳潼,夏玉叶,闵旸.缺血性脑卒中的发病机制及其治疗[J].世界临床药物,2010,31(1):35-39.An YT,Xia YY,Min Y.The pathogenesis of cerebral ischemia and its treatment[J].World Clinical Drugs,2010,31(1):35-39.
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[5]凌倚峰,程忻,杨璐萌.急性缺血性卒中患者静脉溶栓治疗的临床预后影响因素分析[J].中华神经科杂志,2014,47(7):449-454.Ling QF,Cheng X,Yang LM.Efficacy and outcome predictors of intravenous thrombolysis for patients with acute ischemic stroke[J].Chin J Neurol,2014,47(7):449-454.doi:10.3760/cma.j.issn.1006-7876.2014.07.003.
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[7]Song JW,Chung KC.Observational studies:cohort and casecontrol studies[J].Plast Reconstr Surg,2010,126(6):2234-2242.doi:10.1097/PRS.0b013e3181f44abc.
[8]Bang OY,Lee JS,Lee PH,et al.Autologous mesenchymal stem cell transplantation in stroke patients[J].Ann Neurol,2005,57(6):874-882.doi:10.1002/ana.20501.
[9]Shyu WC,Lin SZ,Lee CC,et al.Granulocyte colony-stimulating factor for acute ischemic stroke:a randomized controlled trial[J].CMAJ,2006,174(7):927-933.doi:10.1503/cmaj.051322.
[10]孙洪波,夏圣梅,杨姗杉,等.G-CSF联合自体骨髓间充质干细胞移植治疗急性脑梗死的临床研究[J].中国医师杂志,2008,10(4):441-443.Sun HB,Xia SM,Yang SS,et al.The clinical effect of rhG-CSF combined transplantation of autologous bone marrow mesenchymal stem cells on acute cerebral infarcton[J].Chin Phy J,2008,10(4):441-443.doi:10.3760/cma.j.issn.1008-1372.2008.04.004.
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