自体黑色素细胞移植治疗白癜风的系统评价

    Transplantation of Autologous Melanocytes for Treatment of Vitiligo: A Systematic Review

    • 摘要: 目的 对自体黑色素细胞移植治疗白癜风的方法进行系统分析,以期对其疗效作出客观、可信的评价。 方法 计算机检索Cochrane 图书馆(2013年第2期)、PubMed、 EMBASE、中国生物医学文献数据库、中国期刊全文数据库、万方学位论文数据库,手工检索相关期刊和会议文献,收集所有自体黑色素细胞移植治疗白癜风的有关文献。按照纳入和排除标准筛选。采用Cochrane协作网的RevMan5.1软件进行统计分析。 结果 符合纳入标准的有7篇临床对照试验文献,包括341例患者。Meta分析显示: ①黑色素细胞(培养与非培养)移植治疗效果总体要优于对照组优势比2.92,95%可信区间(1.71,5.00);②自体黑色素细胞(培养或非培养)移植治疗的疗效高于液氮冷冻及紫外线治疗优势比4.00,95%可信区间(1.28,12.49);③黑色素细胞培养移植治疗的疗效肯定,明显优于对照组优势比18.26,95%可信区间(4.81,69.42);④黑色素细胞(培养或非培养)移植治疗与表层上皮移植治疗的疗效无明显区别优势比2.42, 95%可信区间(0.90, 6.53);⑤未行培养直接移植的黑色素细胞与培养的黑色素细胞移植治疗的疗效无明显区别 优势比0.41,95%可信区间(0.11, 1.56)。 结论 稳定期白癜风采用自体黑色素细胞移植治疗,疗效肯定而且比较安全,疗效与解剖部位等有关,而与表层上皮移植治疗的有效性无明显区别,但结果仍有待更多高质量多中心的随机双盲对照试验进一步证实。

       

      Abstract: Objective To evaluate the efficacy and safety of autologous melanocytes for treatment of stable vitiligo. Methods We did a systematic literature search for studies from PubMed, EMBASE, Cochrane Library (Issue 2, 2013), Chinese Biological Medicine Data-base, CNKI and WanFang Database on the internet. All the studies meeting the inclusion criteria were selected. We manually searched current journals and conferences abstracts, relevant reviews and their references. RevMan 5.1 software was used for meta-analysis. Results Seven clinical controlled trials including 341 patients were included. The Results of meta-analyses showed that the efficacy in patients underwent melanocyte transplantation was superior to the control OR=2.92, 95%CI(1.71, 5.00), the efficacy in patients underwent autologous melanocyte transplantation was significantly higher than that in patients who underwent cryostore or ultraviolet therapy OR=4.00, 95%CI(1.28, 12.49). The effect in patients who underwent autologous melanocyte transplantation was significantly higher than controlled cases OR=18.26,95%CI(4.81, 69.42). The autologous melanocyte transplantation and thickness thin skin grafts was equally effective OR=2.42, 95%CI(0.90, 6.53). The efficacy of cultured autologous melanocyte and non-cultured was similarOR=0.41, 95% CI (0.11, 1.56). Conclusions The efficacy of autologous melanocytes for treatment of stable vitiligo is much higher than those traditional therapies, but is equally effective with thickness thin skin grafts transplantation. The Results of transplantation is related to anatomical site and so on. More evidence from high qualified multi-center studies is needed.

       

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