自体角膜缘干细胞移植联合MMC对翼状胬肉疗效的Meta分析

目的:探讨自体角膜缘干细胞移植术联合丝裂霉素(MMC)治疗翼状胬肉对术后复发及角膜上皮修复时间的影响。方法:计算机检索Cochrane Datebase,Pubmed,中国期刊全文数据库、中国知网、维普中文科技期刊数据库、万方数据库。检索时限从建库到2013-02。纳入比较自体角膜缘干细胞移植联合MMC与自体角膜缘干细胞移植治疗翼状胬肉对胬肉复发及角膜上皮修复时间影响的随机对照试验(RCT)。数据统计分析采用Cochrane协作网提供的RevMan5.1软件。结果:共初检出217篇文章,最终纳入12个RCT,共1044眼。对12项RCT进行Meta分析显示:自体角膜缘干细胞移植术联合MMC与单纯自体角膜缘移植术比较,术后复发率有统计学意义(OR=0.23,95%CI:0.15～0.36,Z=6.40,P<0.01);对于其中研究到术后角膜上皮修复时间的6项RCT进行Meta分析显示:自体角膜缘干细胞移植术联合MMC与单纯自体角膜缘移植术比较,术后角膜上皮修复时间无统计学意义(MD=0.62,95%CI:0.62～1.85,Z=0.98,P=0.33)。结论:自体角膜缘干细胞移植术中运用MMC可明显减少术后复发,对角膜上皮修复的时间无明显影响。

Meta-analysis of clinical effectiveness of the treatment of limbal autograft stem cells transplantation with the use of mitomycin-C for pterygium

AIM: To evaluate effectiveness of the treatment of limbal autograft stem cells transplantation combined with the use of mitomycin C(MMC)for pterygium on the postoperative recurrence and repairing time of corneal epithelial.

METHODS: All the relevant reported studies were searched out through Cochrane Datebase, Pubmed, China BioMedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI), VIP and Wanfang Database which published before December 2012. All the randomized controlled trials(RCT)which accessed the recurrence of pterygium by comparing the treatment of limbal autograft stem cells transplantation with the additional use of MMC during limbal autograft stem cells transplantation were included. The data were analyzed by RevMan 5.1 software provided by Cochrane Collaboration Network.

RESULTS: Totally 217 studies were included at first and 12 RCT were included at last. A total of 1 044 eyes were included. Twelve RCT were analyzed with Meta-analysis: the postoperative recurrence rate had statistical significance between limbal autograft stem cells transplantation and limbal autograft stem cells transplantation combined MMC,(OR=0.23,95% CI:0.15-0.36, Z=6.40, P<0.01). Six studies of RCT about repairing time of corneal epithelial showed that repairing time of corneal epithelial had no statistical significance between limbal autograft stem cells transplantation and limbal autograft stem cells transplantation combined MMC by Meta-analysis(MD=0.62, 95% CI: 0.62-1.85, Z=0.98, P=0.33).

CONCLUSION: The application of MMC with the treatment of limbal autograft stem cells transplantation can reduce the recurrence of pterygium, while it has no effect on the repairing time of limbal epithelium.