摘要
目的:系统评价间充质干细胞治疗下肢动脉硬化闭塞症的临床疗效。方法:计算机检索PubMed、Embase、Web of Science、Cochrane Library、Scopus、Google Schola、中国知网、万方、维普、中国生物医学文献数据库,检索间充质干细胞治疗下肢动脉硬化闭塞症的随机对照试验,检索时限均从各数据库建库至2024年7月。按照制定的纳入和排除标准进行文献筛选、提取相关资料。使用RevMan 5.3软件对纳入文献进行Meta分析,包括截肢率、无截肢生存率、溃疡愈合率、踝肱指数、经皮氧分压以及无痛行走距离。结果:共纳入9个随机对照试验。Meta分析结果显示:与对照组比较,间充质干细胞治疗组患者无截肢生存率[RR=1.23,95%CI(1.07,1.42),P=0.004]、截肢率[RR=0.55,95%CI(0.35,0.85),P=0.007]、溃疡愈合率[RR=1.95,95%CI(1.51,2.52),P<0.001]、踝肱指数[MD=0.16,95%CI(0.13,0.19),P<0.001]、经皮氧分压[SMD=1.62,95%CI(0.87,2.37),P<0.001]以及无痛行走距离[MD=131.81,95%CI(3.56,260.06),P=0.04]均有显著改善,但死亡率[RR=1.13,95%CI(0.62,2.06),P=0.68]差异无显著性意义。结论:间充质干细胞对下肢动脉硬化闭塞症的部分临床指标有改善趋势。但由于纳入文献的局限性,未来尚需更多高质量、多中心、大样本的随机对照试验验证。
OBJECTIVE:To systematically evaluate the clinical efficacy of mesenchymal stem cell therapy for the treatment of arteriosclerosis obliterans of lower extremities.METHODS:A comprehensive literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,Scopus,Google Scholar,CNKI,WanFang Data,VIP,and CBM for randomized controlled trials on the use of mesenchymal stem cells in the treatment of arteriosclerosis obliterans of lower extremities.The search covered the period from the inception of each database until July 2024.Relevant studies were screened and data were extracted based on predefined inclusion and exclusion criteria.Meta-analysis was performed using RevMan 5.3 software,including amputation rate,amputation-free survival rate,ulcer healing rate,ankle-brachial index,transcutaneous oxygen pressure,and pain-free walking distance.RESULTS:A total of nine randomized controlled trials were included in the meta-analysis.The meta-analysis results showed that compared with the control group,patients in the mesenchymal stem cell treatment group had significant improvements in amputation-free survival rate[RR=1.23,95%CI(1.07,1.42),P=0.004],amputation rate[RR=0.55,95%CI(0.35,0.85),P=0.007],ulcer healing rate[RR=1.95,95%CI(1.51,2.52),P<0.001],ankle-brachial index[MD=0.16,95%CI(0.13,0.19),P<0.001],transcutaneous oxygen pressure[SMD=1.62,95%CI(0.87,2.37),P<0.001],and pain-free walking distance[MD=131.81,95%CI(3.56,260.06),P=0.04].However,there was no significant difference in mortality[RR=1.13,95%CI(0.62,2.06),P=0.68].CONCLUSION:Mesenchymal stem cell therapy for lower extremity atherosclerotic occlusive disease shows a trend of improvement in some clinical indicators.However,due to the limitations of the included literature,more high-quality,multicenter,and large-sample randomized controlled trials are needed in the future.
作者
王振泽
刘奋德
张瑞
李武军
Wang Zhenze;Liu Fende;Zhang Rui;Li Wujun(First Affiliated Hospital of Xi’an Medical University,Xi’an 710082,Shaanxi Province,China;Xi’an Medical University,Xi’an 710068,Shaanxi Province,China)
出处
《中国组织工程研究》
北大核心
2026年第7期1869-1876,共8页
Chinese Journal of Tissue Engineering Research
关键词
间充质干细胞
动脉粥样硬化
下肢动脉硬化闭塞症
溃疡愈合
外泌体
临床疗效
META分析
随机对照试验
mesenchymal stem cell
atherosclerosis
arteriosclerosis obliterans of lower extremities
ulcer healing
exosome
clinical efficacy
meta-analysis
randomized controlled trial
