干细胞疗法治疗急性慢性肝衰竭患者的临床表现：系统评价

StephenW

Clinical performance of stem cell therapy in patients with acute-on-chronic liver failure: a systematic review and meta-analysis

    Ran Xue, Qinghua MengEmail authorView ORCID ID profile, Jinling Dong, Juan Li, Qinwei Yao, Yueke Zhu and Hongwei Yu

Journal of Translational Medicine201816:126

https://doi.org/10.1186/s12967-018-1464-0

©  The Author(s) 2018

Received: 20 January 2018

Accepted: 27 March 2018

Published: 10 May 2018
Abstract
Background

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.
Methods

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.
Results

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 < 0.00001). There was no obvious change in the INR level compared with the control groups (p = 0.64). The ALB levels increased markedly as compared with the control groups (p < 0.0001). The significant difference can be found in MELD score between stem cell therapy and control groups (p = 0.008). Further subgroup analysis for 3-month clinical performance according to the stem cell types have also been performed.
Conclusion

This study suggests that the clinical outcomes of stem cell therapy were satisfied in patients with ACLF in the short-term. MSCs may be better than BM-MNCs in the stem cells transplantation of ACLF. However, more attention should focus on clinical trials in large-volume centers.
Keywords
Stem cell therapyAcute-on-chronic liver failureClinical performance

StephenW

干细胞疗法治疗急性慢性肝衰竭患者的临床表现：系统评价和荟萃分析

    冉雪，清华大学电子信息学院作者查看ORCID ID简介，金玲栋，李娟，秦勤瑶，朱跃科，余宏伟

Journal of Translational Medicine201816：126

https://doi.org/10.1186/s12967-018-1464-0

©The Author（s）2018

收到日期：2018年1月20日

接受日期：2018年3月27日

发布时间：2018年5月10日
抽象
背景

干细胞疗法已被用于治疗急性慢性肝衰竭（ACLF）。然而，其临床效率仍然值得商榷。本系统评价和荟萃分析的目的是评价干细胞疗法在ACLF治疗中的临床效果。
方法

在2017年12月检索了Cochrane图书馆，OVID，EMBASE和PUBMED。纳入了评估ACLF患者干细胞疗法的随机和非随机研究。结果指标包括总胆红素（TBIL），丙氨酸转氨酶（ALT），国际标准化比值（INR），白蛋白（ALB）和终末期肝病模型（MELD）评分。 GRADEpro评估了证据的质量。
结果

纳入了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个月，3个月和12个月时TBIL水平显着降低（p = 0.0008; p = 0.04; p = 0.007）。短期内ALT水平与对照组相比显着下降（p <0.00001）。 INR水平与对照组相比无明显变化（P = 0.64）。与对照组相比，ALB水平显着增加（p <0.0001）。干细胞治疗组和对照组之间MELD评分存在显着差异（p = 0.008）。还根据干细胞类型进行了3个月临床表现的进一步亚组分析。
结论

这项研究表明干细胞治疗的临床结果在短期内在ACLF患者中是满意的。在ACLF干细胞移植中，MSCs可能优于BM-MNCs。但是，更应关注大批量中心的临床试验。
关键词
干细胞治疗急性慢性肝衰竭的临床表现

StephenW

https://translational-medicine.b ... 6/s12967-018-1464-0