自体干细胞治疗克罗恩病疗效的meta分析

刘志威; 赵利婷; 何京; 陈友鹏

doi:10.12122/j.issn.1674-4500.2019.01.23

自体干细胞治疗克罗恩病疗效的meta分析

doi: 10.12122/j.issn.1674-4500.2019.01.23

刘志威^1,,
赵利婷^1,,
何京²,
陈友鹏^3, ,

1.
惠州市第六人民医院内三科，广东惠州 516211
2.
暨南大学附属第一医院感染科，广东广州 510630
3.
中山大学附属第七医院感染内科，广东深圳 518107

详细信息

作者简介:
刘志威，硕士，住院医师，E-mail: 843517495@qq.com；赵利婷，本科，住院医师，E-mail: litiing919@yeah.net。刘志威与赵利婷共同为第一作者

通讯作者:
陈友鹏，主任医师，教授，博士生导师，E-mail: youpeng.chen@163.com

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出版历程
- 收稿日期: 2018-09-30
- 刊出日期: 2019-01-01

Meta-analysis of effect of autologous stem cells treatment on Crohn's disease

Zhiwei LIU^1
,,
Liting ZHAO^1
,,
Jing HE²,
Youpeng CHEN^{3
, ,}

1.
The Sixth People's Hospital of Huizhou, Huizhou 516211, China
2.
The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
3.
the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China

摘要

摘要: 目的评价自体干细胞治疗对克罗恩病的疗效。方法检索 Pubmed、MEDLINE、EBSCO、Current Content Connect、Cochrane、中国生物医学文献数据库、中国知网、万方数据库、维普数据库、谷歌学术、全国图书馆参考咨询联盟等参考文献，检索年限1963年2月~2018年7月。由2位研究者独立进行数据搜集、评价纳入研究质量、进行资料提取及交叉核对后，对纳入的研究数据使用 RevMan 5.3 软件进行多因素分析，并进行Q检验鉴定研究间异质性, 根据Q检验结果分别采用随机效应和固定效应模型合并研究，同时根据统计项目的不同进行亚组分析。结果检索到相关论文共1048篇，排除动物实验、病例报道及个案，最终纳入13篇论文，其中9个回顾性研究、4个病例对照研究。荟萃分析表明，通过对单臂试验统计干细胞治疗前后总体病情缓解，共纳入9篇文献，分析总体人数与有效人数危险度差，经统计分析后干细胞治疗前后危险度差值有统计学意义（RD=0.81，P<0.00001）。通过进一步统计分析纳入文献经干细胞治疗前后OR值，差异有统计学意义（OR=11，P<0.00001），但克罗恩病疾病活动指数试验组与对照组差异无统计学意义（P=0.13）。结论自体干细胞治疗短期内可减轻克罗恩病患者临床症状，但其安全性及其疗效确切性，有待于进一步明确。
- 干细胞 /
- 克罗恩病 /
- 疗效 /
- 荟萃分析
Abstract: Objective To evaluate the effect of autologous stem cells treatment on Crohn's disease. Methods Published papers and abstracts from Pubmed, MEDLINE, EBSCO, Current Content Connect, Cochrane, China Biomedical Literature Database, China HowNet, Wanfang Database, Wipe Database, Google Academy, National Library Reference and Consulting Union database were screened from February 1963 to July 2008. After independent data collection, evaluation, data extraction and cross-check were done by 2 authors. RevMan 5.3 software was used for multivariate analysis, and Q-test for identifying the heterogeneity between two groups in the study. According to the results of Q-test, random effects and fixed effects models were used and then subgroup analysis was done in this meta-analysis. Results A total of 1048 published papers were found. After both animal experiments and case reports were excluded, 13 papers were finally included, e.g. 9 retrospective studies and 4 case-control studies. Meta-analysis showed that the RD value after stem cell therapy and before therapy was significantly different (RD=0.81, P<0.00001). The OR value after stem cell therapy and before therapy was significantly different (OR=11.00,P<0.00001), but there was no significant difference of the activity index in patients with Crohn's disease between treatment group and control group (P=0.13). Conclusion Autologous stem cells therapy might improve the clinical symptoms in patients with Crohn's disease in a short time, its safety and efficacy are still unclear.
- stem cells /
- Crohn's disease /
- efficacy /
- meta-analysis

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图 2 纳入文献危险度差分析

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图 1 文献筛选流程

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图 4 治疗前纳入文献CDAI指数分析

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图 3 纳入文献OR值分析

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表 1 纳入试验质量评价

研究名称	选择性				可比性	暴露分析
研究名称	病例定义充分性	病例代表性	对照的选择	对照的定义	可比性	暴露的确定	是否采用相同确定方法	无应答率相同
Hawkey 2015	1	1	0	0	1	1	1	0
Julián Panés 2016	1	1	0	1	1	1	1	1
Jian Zhang2018	1	1	0	0	1	1	1	0
Julián Panés2018	1	1	0	1	1	1	1	0

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