嗅鞘细胞移植修复大鼠及人类脊髓损伤的Meta分析

Olfactory ensheathing cells transplantation in repairing spinal cord injury in rat and human: a Meta-analysis

中文关键词:  嗅鞘细胞  脊髓损伤  大鼠  人  Meta分析

英文关键词:Olfactory ensheathing cells  Spinal cord injury  Rat  Human  Meta—analysis

中文摘要:

  【摘要】 目的：综合评价嗅鞘细胞（OECs）移植治疗脊髓损伤（spinal cord injury，SCI）的价值。方法：计算机检索美国国立图书馆（MEDLINE） 、PubMed、Ovid-Medline、Ovid-BIOSIS Previews、CNKI、VIP、CBM数据库中关于嗅鞘细胞移植治疗SCI大鼠及患者的随机对照研究。检索时间均为2000年1月至2012年6月。对符合纳入标准的研究以修改后Jadad量表为标准进行质量评价，收集原始数据，采用RevMan5.0软件进行Meta分析。结果：共28篇文章符合标准，Meta分析显示：15篇以大鼠为模型的实验中，OECs组细胞移植6周后，其后肢运动功能（BBB）评分高于对照组，其差异有统计学意义[WMD=1．24，95％CI（1.12，1.35），P<0．00001]；感觉诱发电位（SEP）潜伏期短于对照组，而波幅高于对照组，其差异有统计学意义[潜伏期WMD=-2.33，95％CI（-3.05，-1.60），P<0．0001；波幅WMD=0.27，95％CI（0.24，0.30），P<0．00001]；运动诱发电位（MEP）波幅高于对照组，差异有统计学意义[MEP振幅WMD=-0.20，95％CI（-0.55，0.15），P<0．00001]；痛觉测量（Plantar test）潜伏期短于对照组，差异有统计学意义[WMD=-1.05，95％CI（-1.38，-0.72），P<0．00001]；受损区脊髓横断面积大于对照组，差异有统计学意义[WMD=0.93，95％CI（0.79，1.07），P<0．00001]。在SCI患者的13篇文献中，OECs移植后患者的运动、轻触觉及痛觉功能评分均高于移植前，差异具有统计学意义[运动 WMD=-5.53，95％CI（-7.04，-4.01），P<0．00001；轻触觉WMD=-11.22，95％CI（-12.98，-9.47）, P<0．0001；痛觉 WMD=-9.65，95％CI（-11.41，-7.88），P<0．000011]。结论：就目前为止的研究结果分析，OECs移植能促进SCI大鼠及人的脊髓再生及功能改善。

英文摘要:

  【Abstract】 Objectives: To comprehensively evaluate the value of olfactory ensheathing cells(OECs) transplantation for spinal cord injury(SCI). Methods: 28 randomized controlled trials were searched from American Medline, PubMed, and Ovid-BIOSIS Previews, CNKI, VIP, CBM databases concerning Olfactory ensheathing cells transplantation in treating spinal cord injury in rat or human between January 2000 and June 2012, all trials were assessed by quantitative analysis by using modified Jadad scale, and the available data were extracted and Meta-analyzed with RevMan 5.0 software． Results: Meta-analysis of 15 controlled studies in rat showed that OECs group was higher than control group in BBB score[WMD=1．24, 95％CI(1.12，1.35), P<0．00001], SEP amplitude[WMD=0.27, 95％CI(0.24, 0.30), P<0．00001], MEP amplitude[WMD=-0.20, 95％CI(-0.55, 0.15), P<0．00001] and the spinal cord cross-sectional area in damaged area[WMD=0.93, 95％CI(0.79, 1.07), P<0．00001]; OECs group was lower than control group in both SEP latency period[WMD=-2.33, 95％CI(-3.05, -1.60), P<0．0001] and Plantar test latency period[WMD=-1.05, 95％CI(-1.38, -0.72), P<0．00001]. All differences had statistical significance. Meta-analysis of 13 controlled studies in human showed that pre-transplantion group was higher than post-transplantion group in motion, light touch and sore score, which showed statistical significance, too[motion WMD=-5.53, 95％CI(-7.04, -4.01), P<0．00001; light touch WMD=-11.22, 95％CI(-12.98, -9.47), P<0．0001; sore WMD=-9.65, 95％CI(-11.41, -7.88), P<0．000011]. Conclusions: Results of Meta-analysis show that OECs transplantation is able to promote spinal cord regeneration and spinal cord function recovery in rat or human with SCI based on the current trials.