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Umbilical cord blood stem cells transplantation as an adjunctive treatment strategy for liver cirrhosis in Chinese population: a meta-analysis of effectiveness and safety

机译:脐血干细胞移植作为中国人群肝硬化的辅助治疗策略:有效性和安全性的荟萃分析

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Objective: The aim of the study was to evaluate the efficacy and safety of umbilical cord blood stem cells (USCs) transplantation combined with routine supportive therapy (RST) for liver cirrhosis (LC). Materials and methods: Clinical trials involved in this research were searched from Web of Science, PubMed, EMBASE, Cochrane Library, Wanfang and CNKI database. Treatment effects, quality of life (QoL), adverse events and other outcome measures were extracted and evaluated. Results: A total of 10 trials including 616 LC patients were involved in this study. Based on our analysis, the liver function of LC patients was significantly improved after USCs transplantation and RST combined therapy, indicated by decreased total bilirubin, alanine aminotransferase, aspartate aminotransferase levels and prothrombin time and increased serum albumin level and prothrombin activity. Compared to those treated by RST alone, patients treated by combined therapy showed more satisfied treatment effects, improved QoL reflected by improved appetite (odds ratio [OR]=5.43, 95% CI=2.84 to 10.38, P <0.00001) and relieved fatigue (OR=4.33, 95% CI=0.87 to 21.60, P =0.07), ascetic fluid (OR=4.56, 95% CI=2.69 to 7.74, P <0.00001), abdominal distension (OR=4.01, 95% CI=1.34 to 12.02, P =0.01) and edema (OR=2.69, 95% CI=0.23 to 31.72, P =0.43). No serious adverse events occurred during USCs therapy. Conclusion: USCs transplantation is a safe and effective adjuvant therapy for RST-treated LC, possibly through improving patients’ liver function.
机译:目的:本研究的目的是评估脐带血干细胞(USCs)移植与常规支持疗法(RST)联合治疗肝硬化(LC)的疗效和安全性。材料和方法:参与这项研究的临床试验从Web of Science,PubMed,EMBASE,Cochrane图书馆,Wanfang和CNKI数据库中进行搜索。提取并评估治疗效果,生活质量(QoL),不良事件和其他结果指标。结果:这项总共10项试验包括616名LC患者。根据我们的分析,USCs移植和RST联合治疗后,LC患者的肝功能显着改善,表现为总胆红素,丙氨酸氨基转移酶,天冬氨酸氨基转移酶水平和凝血酶原时间减少,血清白蛋白水平和凝血酶原活性增加。与仅接受RST治疗的患者相比,联合治疗的患者表现出更满意的治疗效果,改善的QoL(食欲比[OR] = 5.43、95%CI = 2.84至10.38,P <0.00001)和缓解的疲劳感( OR = 4.33,95%CI = 0.87至21.60,P = 0.07),腹水(OR = 4.56,95%CI = 2.69至7.74,P <0.00001),腹胀(OR = 4.01,95%CI = 1.34至12.02,P = 0.01)和水肿(OR = 2.69,95%CI = 0.23至31.72,P = 0.43)。 USCs治疗期间未发生严重的不良事件。结论:USCs移植可能是通过改善患者的肝功能而对RST治疗的LC安全有效的辅助治疗。

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