Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (13): 2126-2132.doi: 10.3969/j.issn.2095-4344.2049
Changes of cardiac function in rats with myocardial
infarction after umbilical cord-derived mesenchymal stem cell transplantation:
a meta-analysis
Chen Siyu1, Zhang Tao2, Yin Wenjuan3, Cai Lei2, Li Yannan1, Xie Liying1, Zuo Lin1
- 1Key Laboratory of Cellular Physiology of Ministry of Education, Shanxi Provincial Key Laboratory, Department of Physiology, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China; 2Department of Applied Psychology, 3School of Basic Medical Sciences, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
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Received:2019-08-26Revised:2019-08-31Accepted:2019-10-15Online:2020-05-08Published:2020-03-11 -
Contact:Zuo Lin, MD, Associate professor, Key Laboratory of Cellular Physiology of Ministry of Education, Shanxi Provincial Key Laboratory, Department of Physiology, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China -
About author:Chen Siyu, Master candidate, Key Laboratory of Cellular Physiology of Ministry of Education, Shanxi Provincial Key Laboratory, Department of Physiology, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China -
Supported by:the Shanxi Provincial Youth Foundation, No. 201601D202106; the Scientific Research Fund for Returned Overseas Students in Shanxi Province, No. 2014-036; the Key Subject Construction of Shanxi “1331 Project” (1331KSC), No. XK201708
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Cite this article
Chen Siyu, Zhang Tao, Yin Wenjuan, Cai Lei, Li Yannan, Xie Liying, Zuo Lin.
Changes of cardiac function in rats with myocardial
infarction after umbilical cord-derived mesenchymal stem cell transplantation:
a meta-analysis
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2.1 文献检索结果 根据检索策略，共检索出相关文献421篇，通过Endnote软件排除重复文献123篇，剩下的文献通过阅读题目、摘要和全文，排除不符合要求文献289篇，最终纳入文章9篇[24-32]，进行研究的大鼠共计216只，详见图1。 "
2.2 纳入研究的基本特征及质量评价 纳入研究的基线特征和质量评价见表1，根据Cochrane协作网的偏倚风险评价标准，文献质量均为B级。 "
2.3 Meta分析结果 2.3.1 左室射血分数Meta分析结果 9篇文献报道了脐带间充质干细胞对大鼠心肌梗死后左室射血分数的影响[24-32]，根据2周、4周和4周以后3个评价结局指标时间以及心室内注射和梗死心肌周围注射2种注射部位，将纳入的9篇文献分为5个亚组，进行了组间的差异对比分析。由于各研究结果之间存在异质性(I2 > 50%)，故采用随机效应模型进行Meta分析。结果显示：①2周时，脐带间充质干细胞组的左室射血分数显著高于对照组，差异有显著性意义[SMD=5.85，95%CI (4.82，6.89)，P=0.003]，I2=89.0%，组内异质性高；②4周时，脐带间充质干细胞组的左室射血分数显著高于对照组，差异有显著性意义[SMD=2.98，95%CI(2.45，3.51)，P=0.001]，I2=78.6%，组内异质性较高；③4周之后，脐带间充质干细胞组的左室射血分数显著高于对照组，差异有显著性意义[SMD=2.92，95%CI (1.95，3.90)，P=0.003]，I2=88.3%，组内异质性较高；④心室内注射，脐带间充质干细胞组的左室射血分数显著高于对照组，差异有显著性意义[SMD=5.94，95%CI (5.08，6.81)，P=0.020]，I2=29.4%，亚组内异质性低；⑤梗死区附近心肌注射，脐带间充质干细胞组的左室射血分数显著高于对照组，差异有显著性意义[SMD=2.65，95%CI (2.16，3.14)，P=0.028]，I2=43.8%，亚组内异质性较低，见图2。 "
2.3.2 左室短轴缩短率Meta分析结果 7篇文献报道了脐带间充质干细胞对大鼠心肌梗死后左室短轴缩短率的影 响[26-32]，根据4周和4周以后2个评价结局指标时间以及心室内注射和梗死心肌周围注射2种注射部位，将纳入的7篇文献分为4个亚组，进行了组间的差异对比分析。因为各研究结果之间存在异质性(I2 > 50%)，故采用随机效应模型进行Meta分析。结果显示：①4周时，脐带间充质干细胞组的左室短轴缩短率显著高于对照组，差异有显著性意义[SMD=0.36，95%CI (0.07，0.65)，P < 0.001]，I2=87.3%，组内异质性高；②4周以后，脐带间充质干细胞组的左室短轴缩短率显著高于对照组，差异有显著性意义[SMD=0.37，95%CI (-0.19，0.94)，P < 0.001]，I2=77.3%，组内异质性较高；③梗死区附近心肌注射，脐带间充质干细胞组的左室短轴缩短率显著高于对照组，差异有显著性意义[SMD=0.49，95%CI (0.18，0.80)，P=0.004]，I2=0.0%，亚组内异质性小；④心室内注射，脐带间充质干细胞组的左室短轴缩短率显著高于对照组，差异有显著性意义[SMD=0.06，95%CI (-0.40，0.53)，P=0.002]，I2=46.1%，亚组内异质性较小，见图3。 "
2.3.3 左室舒张末期内径和左室收缩末期内径Meta分析结果 5篇文献报道了脐带间充质干细胞对大鼠心肌梗死后左室舒张末期内径和左室收缩末期内径的影响[26-27，29-30，32]，根据心室内注射和梗死心肌周围注射2种注射部位，将纳入的4篇文献分为2个亚组，进行了组间的差异对比。由于各研究关于左室舒张末期内径和左室收缩末期内径的异质性检验结果显示异质性较高(I2 > 50%)，故使用随机效应模型进行分析。结果显示：①梗死区周围心肌组织注射脐带间充质干细胞移植治疗对大鼠心肌梗死后的左室舒张末期内径有显著减小作用，其疗效优于对照组，两组间差异有显著性意义[SMD=-1.77，95%CI (-2.43，-1.10)，P=0.032]，I2=0.0%，组内异质性较小；而心室内注射时两组差异无显著性意义[SMD=-1.16，95%CI (-1.78，-0.53)，P=0.291]，I2=10.2%，组内异质性较小，见图4；②梗死区附近心肌注射脐带间充质干细胞移植治疗的左室收缩末期内径显著小于对照组，差异有显著性意义[SMD=-5.67，95%CI (-6.98，-4.36)，P=0.034]，I2=45.2%，亚组内异质性低；心室内注射脐带间充质干细胞移植治疗的左室收缩末期内径显著高于对照组，差异有显著性意义[SMD=-5.54，95%CI (-6.94，-4.13)，P < 0.001]，I2= 94.3%，组内异质性高，见图5。 "
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2.3.4 左室舒张末期容积和左室收缩末期容积Meta分析结果 4篇文献报道了脐带间充质干细胞对大鼠心肌梗死后左室舒张末期容积和左室收缩末期容积的影响[24-26，31]，根据结局指标评价时间不同，将纳入的4篇文献分为2个亚组，进行了组间的差异对比。由于各研究关于左室舒张末期容积和左室收缩末期容积的异质性检验结果显示异质性较高(I2 > 50%)，故使用随机效应模型进行分析。结果显示：①2周时，脐带间充质干细胞组的左室舒张末期容积显著优于对照组，差异有显著性意义[SMD=-1.16，95%CI (-1.68，-0.64)，P < 0.001]，I2=96.9%，但亚组内异质性高；4周时，脐带间充质干细胞组的左室舒张末期容积相对于对照组显著改善，差异有显著性意义[SMD=-2.85，95%CI (-3.78，-1.92)，P < 0.001]，I2=93.9%，亚组内异质性较高，见图6；②2周时，脐带间充质干细胞组的左室收缩末期容积显著小于对照组，差异有显著性意义[SMD=-2.42，95%CI (-3.11，-1.73)，P < 0.001]，I2=98.0%，亚组内异质性高；4周时，脐带间充质干细胞组的左室收缩末期容积相对于对照组显著改善，差异有显著性意义[SMD=-5.08，95%CI (-6.76，-3.40)，P < 0.001]，I2=97.4%，亚组内异质性高，见图7。 "
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