干細胞移植治療腦卒中的系統評價_《中國循證醫學雜志》

作者：

袁勇 ¹ , 曾筱茜 ¹ ,  吳泰相 ²

1.四川大學華西臨床醫學院（成都 610041）2. 四川大學華西醫院中國循證醫學/Cochrane中心（成都 610041）;

關鍵詞：

腦卒中干細胞移植系統評價

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目的　系統評價干細胞移植治療腦卒中患者的有效性和安全性。
方法　檢索CENTRAL (2007年4月)、MEDLINE (1966年至2007年4月)、EMBase (1980年至2007年4月)等資源庫，納入干細脆移植治療腦卒中的臨床研究，并按照Juni等的標準對納入研究的質量進行評價，對干細胞治療在病死率、功能性結局、認知功能改善、影像學改變、生命質量和副作用等方面的效果進行評估。二分類變量以相對危險度及其95%表示；連續性變量以加權均數差及其試驗95%CI表示。統計分析采用RevMan軟件。
結果　納入3個隨機對照，1個歷史回顧性研究，共69例。其中1個試驗報告了不同治療對于病死率的影響，顯示干細胞移植與僅使用常規療法相比，并不能降低患者病死率[RR 0.11, 95%CI（0.01,2.31）, P = 0.16]。有3個研究的結果顯示干細胞移植能改善某些功能性結局，與對照組相比結果有統計學意義。另有一篇文章報告干細胞移植可改善認知功能。一個試驗顯示與對照組比較，干細胞移植顯著提高了患者生活質量。
結論　現有證據還不足以證明干細胞移植治療腦卒中患者安全、有效。評價干細胞移植對于腦卒中的作用還有賴于更多高質量且大規模的隨機對照試驗。

引用本文： 袁勇,曾筱茜,吳泰相. 干細胞移植治療腦卒中的系統評價. 中國循證醫學雜志, 2007, 07(10): 743-749. doi: 復制

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1. William A. Pulsinelli. Cerebrovascular Diseases-principles. In: Lee Goldman, J. Claude Bennett, eds. Cecil Textbook of Medicine. Philadelphia: Saunders, 2000: 2092.
2. American Heart Association. Heart disease and stroke statistics – 2006 update. www. Stroke Association. Org.
3. American Heart Association. Heart disease and stroke statistics – 2006 update. Circulation, 2006, 133: 85.
4. Will iam A, Pulsinelli. Cerebrovascular disease-principles. In: Goldman L, Bennett JC. Editor-in-Chief. Cecil Textbook of Medicine. Philadelphia: Saunders. 2000: 2523.
5. Bang OY, Lee JS, Lee PH, et al. Autologous mesenchymal stem cell transplantation in stroke patients. Ann Neurol, 2005, 57: 874.
6. Zivin JA, Choi DW. Stroke therapy. Science of American, 1991, 265: 56.
7. Kondziolka D, Wechsler L, Goldstein S, et al. Transplantation of cultured human neuronal cells for patients with stroke. Neurology, 2000, 55: 565.
8. Meltzer CC, Kondziolka D, Villemagne VL, et al. Serial[18F] fluorodeoxyglucose positron emission tomography after human neuronal implantation for stroke. Neurosurgery, 2001, 49: 586.
9. Nelson PT, Kondziolka D, Wechsler L, et al. Clonal human (hNT) neuron grafts for stroke therapy: neuropathology in a patient 27 months after implantation. Am J Sci, 2002, 160: 1201.
10. Savitz SI, Dinsmore J, Wu J, et al. Neurotransplantation of fetal porcine cells in patients with basal ganglia infarcts: a preliminary safety and feasibility study. Cerebrovasc Dis, 2005, 20: 101.
11. Wechsler L. Stem cell transplantation for stroke. Hong Kong Med J, 2001, 7: 9.
12. Bl iss T, Guzman R, Daadi M, et al. Cell transplantation therapy for stroke. Stroke, 2007, 38: 817.
13. Kornblurm HI. Introduction to neural stem cells. Stroke, 2007, 38: 810.
14. Wechsler L. Stem cell transplantation for stroke. Cleve Clin J Med, 2004, 71: 40.
15. Juni P, Altman DG, Egger M. Systematic reviews in health care: assessing the quality of randomized controlled trials. BMJ, 2001, 323: 42.
16. Kondziolka D, Steinberg GK, Wechsler L, et al. Neurotransplantation for patients with subcortical motor stroke: a phase 2 randomized trial. J Neurosurg, 2005, 103: 38.
17. Stilley C, Ryan CM, Kondziolka D, et al. Changes in cognitive function after neuronal cell transplantation for basal gangl ia stroke. Neurology, 2004, 63: 1320.
18. Rabinovich SS, Seledtsov VI, Banul NV, et al. Cell therapy of brain stroke. Bull Exp Biol Med, 2005, 139: 126.

《中國循證醫學雜志》

干細胞移植治療腦卒中的系統評價

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《中國循證醫學雜志》

干細胞移植治療腦卒中的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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