干细胞移植治疗糖尿病下肢血管病变的Meta分析

目的:干细胞移植己用于糖尿病下肢血管病变的临床治疗,因各研究样本量小,研究结论不一致.文章系统评价干细胞移植治疗糖尿病下肢血管病变的有效性和安全性.方法:计算机检索PubMed、The Cochrane Library(2019年第11期)、EMbase、中国知网、CBM、维普、万方数据库中干细胞移植治疗糖尿病下肢血管...

Stem cell transplantation for diabetic patients with lower-extremity arterial disease:a meta-analysis

OBJECTIVE:Stem cell transplantation has been used in the clinical treatment of diabetic lower limb vascular diseases.The conclusions were inconsistent due to the small sample size of each study.This article systematically reviewed the safety and efficacy of stem cells transplantation for diabetic patients with lowerextremity arterial disease.METHODS:PubMed,The Cochrane Library(Issue 11,2019),EMbase,CNKI,CBM,VIP and Wanfang databases were electronically searched to collect randomized controlled trials of stem cell transplantation for diabetic patients with lower-extremity arterial disease from inception to December 10,2019.Two reviewers independently screened literature,extracted data and assessed risk of bias of included studies.Meta-analysis was then performed using RevMan 5.3 software.RESULTS:A total of 13 randomized controlled trials involving 546 patients,with 287 patients in stem cell transplantation group and 259 patients in conventional treatment group were included.The meta-analysis results showed that compared with the conventional treatment group,stem cell transplantation could significantly decrease the rate of lower limb amputation(RR=0.29,95%CI:0.10-0.84,P=0.02),improve the collateral angiogenesis(RR=3.16,95%CI:2.12-4.70,P<0.00001),increase ankle brachial pressure index(MD=0.17,95%CI:0.10-0.24,P<0.00001),transcutaneous oxygen pressure(MD=7.71,95%CI:3.99-11.43,P<0.00001),skin temperature(MD=1.90,95%CI:1.28-2.53,P<0.00001)and intermittent limp distance(MD=150.61,95%CI:43.49-257.74,P=0.006),reduce the scores of rest pain(MD=-1.16,95%CI:-1.92 to-1.30,P<0.00001),and cold feeling(MD=-2.00,95%CI:-2.49 to-1.50,P<0.00001).No severe complications such as death,neoplasm,or hepatorenal function impairment were observed in all of our included studies.CONCLUSION:Stem cell transplantation maybe an effective and safe therapeutic method for diabetic patients with lower-extremity arterial disease.However,due to the limited quantity and quality of included studies,more high-quality,long-term follow-up and large sample size randomized controlled trials are needed to confirm the above conclusions.