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首页> 外文期刊>Journal of Translational Medicine >Clinical performance of stem cell therapy in patients with acute-on-chronic liver failure: a systematic review and meta-analysis
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Clinical performance of stem cell therapy in patients with acute-on-chronic liver failure: a systematic review and meta-analysis

机译:干细胞治疗在急性慢性肝功能衰竭中的临床表现:系统评价和荟萃分析

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Stem cell therapy has been applied in the treatment of acute-on-chronic liver failure (ACLF). However, its clinical efficiency is still debatable. The aim of this systematic review and meta-analysis is to evaluate the clinical efficiency of stem cell therapy in the treatment of ACLF. The Cochrane Library, OVID, EMBASE, and PUBMED were searched to December 2017. Both randomized and non-randomized studies, assessing stem cell therapy in patients with ACLF, were included. The outcome measures were total bilirubin (TBIL), alanine transaminase (ALT), international normalized ratio (INR), albumin (ALB), and the model for end-stage liver disease (MELD) score. The quality of evidence was assessed by GRADEpro. Four randomized controlled trials and six non-randomized controlled trials were included. The TBIL levels significantly decreased at 1-, 3-, 12-month after the stem cell therapy (p?=?0.0008; p?=?0.04; p?=?0.007). The ALT levels decreased significantly compared with the control group in the short-term (p?
机译:干细胞疗法已用于治疗慢性慢性肝功能衰竭(ACLF)。但是,其临床疗效尚有争议。该系统评价和荟萃分析的目的是评估干细胞疗法在治疗ACLF中的临床效率。检索截止到2017年12月的Cochrane库,OVID,EMBASE和PUBMED。包括随机和非随机研究,评估ACLF患者的干细胞治疗。结果指标为总胆红素(TBIL),丙氨酸转氨酶(ALT),国际标准化比率(INR),白蛋白(ALB)和终末期肝病模型(MELD)评分。证据质量由GRADEpro评估。包括四项随机对照试验和六项非随机对照试验。干细胞治疗后1、3、12个月,TBIL水平显着下降(p = 0.0008; p = 0.04; p = 0.007)。与对照组相比,ALT水平在短期内显着下降(p 0.00001)。与对照组相比,INR水平无明显变化(p≥0.64)。与对照组相比,ALB水平显着增加(p << 0.0001)。在干细胞治疗组和对照组之间,MELD评分存在显着差异(p = 0.008)。还根据干细胞类型对3个月临床表现进行了进一步的亚组分析。这项研究表明,短期内ACLF患者的干细胞治疗临床效果令人满意。在ACLF的干细胞移植中,MSC可能比BM-MNC更好。但是,更多的注意力应该集中在大型中心的临床试验上。

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