...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Neural regeneration research >Stem cell transplantation for spinal cord injury: a meta-analysis of treatment effectiveness and safety
【24h】

Stem cell transplantation for spinal cord injury: a meta-analysis of treatment effectiveness and safety

机译：干细胞移植治疗脊髓损伤：治疗效果和安全性的荟萃分析

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: The aim of this study was to evaluate the effectiveness and safety of stem cell transplantation for spinal cord injury (SCI). DATA SOURCES: PubMed, EMBASE, Cochrane, China National Knowledge Infrastructure, China Science and Technology Journal, Wanfang, and SinoMed databases were systematically searched by computer to select clinical randomized controlled trials using stem cell transplantation to treat SCI, published between each database initiation and July 2016. DATA SELECTION: Randomized controlled trials comparing stem cell transplantation with rehabilitation treatment for patients with SCI. Inclusion criteria: (1) Patients with SCI diagnosed according to the American Spinal Injury Association (ASIA) International standards for neurological classification of SCI; (2) patients with SCI who received only stem cell transplantation therapy or stem cell transplantation combined with rehabilitation therapy; (3) one or more of the following outcomes reported: outcomes concerning neurological function including sensory function and locomotor function, activities of daily living, urination functions, and severity of SCI or adverse effects. Studies comprising patients with complications, without full-text, and preclinical animal models were excluded. Quality of the included studies was evaluated using the Cochrane risk of bias assessment tool and RevMan V5.3 software, provided by the Cochrane Collaboration, was used to perform statistical analysis. OUTCOME MEASURES: ASIA motor score, ASIA light touch score, ASIA pinprick score, ASIA impairment scale grading improvement rate, activities of daily living score, residual urine volume, and adverse events. RESULTS: Ten studies comprising 377 patients were included in the analysis and the overall risk of bias was relatively low level. Four studies did not detail how random sequences were generated, two studies did not clearly state the blinding outcome assessment, two studies lacked blinding outcome assessment, one study lacked follow-up information, and four studies carried out selective reporting. Compared with rehabilitation therapy, stem cell transplantation significantly increased the lower limb light touch score (odds ratio (OR) = 3.43, 95% confidence interval (CI): 0.01 – 6.86, P = 0.05), lower limb pinprick score (OR = 3.93, 95%CI: 0.74 – 7.12, P = 0.02), ASI grading rate (relative risk (RR) = 2.95, 95%CI: 1.64 – 5.29, P = 0.0003), and notably reduced residual urine volume (OR = –8.10, 95%CI: –15.09 to –1.10, P = 0.02). However, stem cell transplantation did not significantly improve motor score (OR = 1.89, 95%CI: –0.25 to 4.03, P = 0.08) or activities of daily living score (OR = 1.12, 95%CI: –1.17 to 4.04, P = 0.45). Furthermore, stem cell transplantation caused a high rate of mild adverse effects (RR = 14.49, 95%CI: 5.34 – 34.08, P CONCLUSION: Stem cell transplantation was determined to be an efficient and safe treatment for SCI and simultaneously improved sensory and bladder functions. Although associated minor and temporary adverse effects were observed with transplanted stem cells, spinal cord repair and axon remyelination were apparent. More randomized controlled trials with larger sample sizes and longer follow-up times are needed to further validate the effectiveness of stem cell transplantation in the treatment of SCI.
机译：目的：本研究旨在评估干细胞移植对脊髓损伤（SCI）的有效性和安全性。资料来源：计算机系统地搜索了PubMed，EMBASE，Cochrane，中国国家知识基础设施，中国科学技术期刊，万方和SinoMed数据库，以选择使用干细胞移植治疗SCI的临床随机对照试验，并在每次数据库启动与2016年7月。数据选择：比较SCI患者干细胞移植与康复治疗的随机对照试验。纳入标准：（1）根据美国脊髓损伤协会（ASIA）国际标准对SCI进行诊断的SCI患者; （2）仅接受干细胞移植治疗或干细胞移植联合康复治疗的SCI患者; （3）报告了以下一项或多项结果：与神经功能有关的结果，包括感觉功能和运动功能，日常生活活动，排尿功能以及SCI严重程度或不良反应。排除了包括并发症但没有全文的患者以及临床前动物模型在内的研究。使用Cochrane偏倚风险评估工具评估纳入研究的质量，并使用Cochrane Collaboration提供的RevMan V5.3软件进行统计分析。观察指标：ASIA运动评分，ASIA轻触评分，ASIA针刺评分，ASIA损伤量表分级改善率，日常生活活动量，残留尿量和不良事件。结果：10项研究包括377例患者，被纳入分析，总体偏倚风险相对较低。有4项研究没有详细说明随机序列的产生方式，有2项研究没有明确陈述盲目的结果评估，有2项研究缺乏盲目的结果评估，一项研究缺乏随访信息，还有4项研究进行了选择性报告。与康复治疗相比，干细胞移植显着增加了下肢轻触评分（优势比（OR）= 3.43，95％置信区间（CI）：0.01 – 6.86，P = 0.05），下肢针刺评分（OR = 3.93） ，95％CI：0.74 – 7.12，P = 0.02），ASI分级率（相对风险（RR）= 2.95，95％CI：1.64 – 5.29，P = 0.0003），并且尿液残留量显着减少（OR = –8.10） ，95％CI：–15.09至–1.10，P = 0.02）。但是，干细胞移植并不能显着改善运动评分（OR = 1.89，95％CI：–0.25至4.03，P = 0.08）或日常生活活动评分（OR = 1.12，95％CI：–1.17至4.04，P = 0.45）。此外，干细胞移植引起较高的轻度不良反应（RR = 14.49，95％CI：5.34 – 34.08，P）结论：干细胞移植被认为是治疗SCI的有效且安全的方法，同时改善了感觉和膀胱功能尽管移植的干细胞观察到了相关的轻微和暂时的不良反应，但脊髓修复和轴突髓鞘再生很明显，需要更多的具有更大样本量和更长随访时间的随机对照试验来进一步验证干细胞移植的有效性。 SCI的治疗。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号