背景:在一些临床试验中已经证明了自体皮肤细胞悬液(ASCS)的成功使用。然而,其有效性和安全性尚未得到验证。这项最新的系统评价和荟萃分析旨在研究自体表皮细胞悬液在皮肤病变再上皮化中的作用。
方法:相关文章来自PubMed,Embase,Cochrane数据库,WebofScience,国际临床试验注册平台,中国国家知识基础设施,中国科技期刊VIP数据库和万方数据库。主要的输出测量是愈合时间,次要产出是有效率,用于治疗的供体部位的大小,研究治疗区域的大小,操作时间,疼痛评分,色素沉着,并发症,瘢痕量表评分和满意度评分。将数据汇总并表示为相对风险(RR),平均差(MD)和标准化平均差(SMD),置信区间为95%。
结果:本系统综述和荟萃分析包括31项研究,914例患者接受自体表皮细胞悬液(治疗组)和883例患者接受标准治疗或安慰剂(对照组)。所有纳入研究的汇总数据表明,治疗组的愈合时间显着缩短(SMD=-0.86;95%CI:-1.59-0.14;p=0.02,I2=95%),治疗部位的大小(MD=-115.41;95%CI:-128.74-102.09;p<0.001,I2=89%),手术时间(MD=25.35;95%CI:23.42-27.29;p<0.001,I2=100%),疼痛评分(SMD=-1.88;95%CI:-2.86-0.90;p=0.0002,I2=89%)和并发症(RR=0.59;95%CI:0.36-0.96;p=0.03,I2=66%),以及显效率显着增加(RR=1.20;95%CI:1.01-1.42;p=0.04,I2=77%)。研究处理区的大小无显著差异,色素沉着,比较两组患者的瘢痕量表评分和满意度评分。
结论:我们的荟萃分析表明,自体表皮细胞悬液有利于皮肤病变的再上皮化,因为它们显着缩短了愈合时间,治疗部位的大小,操作时间,疼痛评分和并发症,以及提高有效率。然而,这种干预对治疗面积的影响很小,色素沉着,瘢痕量表评分和满意度评分。
BACKGROUND: Successful usage of autologous skin cell suspension (ASCS) has been demonstrated in some clinical trials. However, its efficacy and safety have not been verified. This latest systematic review and meta-analysis aim to examine the effects of autologous epidermal cell suspensions in re-epithelialization of skin lesions.
METHODS: Relevant articles were retrieved from PubMed, Embase, Cochrane Database, Web of Science, International Clinical Trials Registry Platform, China National Knowledge Infrastructureris, VIP Database for Chinese Technical Periodicals and Wanfang database. The primary output measure was the healing time, and the secondary outputs were effective rate, size of donor site for treatment, size of study treatment area, operation time, pain scores, repigmentation, complications, scar scale scores and satisfaction scores. Data were pooled and expressed as relative risk (RR), mean difference (MD) and standardized mean difference (SMD) with a 95% confidence interval (CI).
RESULTS: Thirty-one studies were included in this systematic review and meta-analysis, with 914 patients who received autologous epidermal cell suspensions (treatment group) and 883 patients who received standard care or placebo (control group). The pooled data from all included studies demonstrated that the treatment group has significantly reduced healing time (SMD = -0.86; 95% CI: -1.59-0.14; p = 0.02, I2 = 95%), size of donar site for treatment (MD = -115.41; 95% CI: -128.74-102.09; p<0.001, I2 = 89%), operation time (MD = 25.35; 95% CI: 23.42-27.29; p<0.001, I2 = 100%), pain scores (SMD = -1.88; 95% CI: -2.86-0.90; p = 0.0002, I2 = 89%) and complications (RR = 0.59; 95% CI: 0.36-0.96; p = 0.03, I2 = 66%), as well as significantly increased effective rate (RR = 1.20; 95% CI: 1.01-1.42; p = 0.04, I2 = 77%). There were no significant differences in the size of study treatment area, repigmentation, scar scale scores and satisfaction scores between the two groups.
CONCLUSIONS: Our meta-analysis showed that autologous epidermal cell suspensions is beneficial for re-epithelialization of skin lesions as they significantly reduce the healing time, size of donar site for treatment, operation time, pain scores and complications, as well as increased effective rate. However, this intervention has minimal impact on size of treatment area, repigmentation, scar scale scores and satisfaction scores.