摘要
脐带血作为一种备选的移植用造血干细胞,能否成功植入与输入受者体内的总有核细胞(total nucleated cells,TNC)数、CD34+细胞数及粒-巨噬细胞集落形成单位(colony-forming unit-granulocyte-macrophage,CFU-GM)有关。本研究探讨影响脐带血造血潜能的母体及新生儿因素。按照广州脐血库标准化操作常规(SOP),对脐带血样本进行筛选、处理、检测及冷冻,回顾性分析已保存的4615份脐带血样本的造血细胞参数及其与母体及新生儿特征的相关性。结果表明:脐带血采集量(Mean±SD:95.23±22.42ml;Median:91.85ml)与处理前TNC[Mean±SD:(1.34±0.49)×109;Median:1.25×109]及处理后TNC[Mean±SD:(1.21±0.42)×109;Median:1.14×109]、CD34+细胞数[Mean±SD:(5.14±4.55)×106;Median:4.08×106]、CFU-GM[Mean±SD:(9.72±8.66)×105;Median:7.53×105]三者均显著相关(p<0.001)。在供者因素中,只有婴儿出生体重与脐带血采集量及造血细胞参数均呈显著正相关(p<0.001),较大婴儿的脐带血在采集量、TNC、CD34+细胞数及CFU-GM方面均呈现优势(p<0.001)。母亲年龄与上述各项参数均无显著相关。孕龄与处理前/后TNC正相关(p<0.001;p<0.001),与CD34+细胞数呈负相关(p=0.04),而与采集量及CFU-GM均无显著相关。剖宫产时采集的脐带血量虽然高于阴道分娩(Mean±SD:97.05ml±22.23mlvs.92.53ml±22.43ml;Median:94.08mlvs.88.82ml;p<0.001),但各细胞参数均低于阴道分娩(p<0.001)。男婴脐带血的采集量和CD34+细胞数高于女婴(Mean±SD:96.41ml±22.31mlvs.93.95ml±22.47ml;Median:93.27mlvs.90.14ml;p<0.001);[Mean±SD:(5.28±5.04)×106vs.(5.00±3.94)×106;Median:4.18×106vs.3.94×106;p=0.042]、但处理前TNC及处理后TNC均低于女婴[Mean±SD:(1.31±0.50)×109vs.(1.37±0.47)×109;Median:1.22×109vs.1.28×109;p<0.001];[Mean±SD:(1.18±0.42)×109vs.(1.24±0.41)×109;Median:1.10×109vs.1.17×109;p<0.001],二者CFU-GM的差异无统计学意义。结论:本研究数据有助于优化脐带血供者筛选及提高脐血库资
Umbilical cord blood （UCB） is an alternative source of hematopoietic stem cells for transplantation with success being associated with the total nucleated cell （TNC） count, CD34＋ cells and colony-forming unit-granulocyte-macrophage（CFU-GM） content infused. This study was purposed to clarify the impact of maternal and neonatal factors on hematopoietic potential of UCB product. UCB samples were screened, processed, tested and cryopreserved according to the Standard Operation Procedure （SOP） of Guangzhou cord blood bank （GZCBB）. Relationship of hematopoietic cell parameters with maternal and neonatal characteristics for 4615 UCB units was analyzed retrospectively. The results showed that both collected volume （Mean±SD： 95.23±22.42 ml; Median： 91.85 ml） and initial TNC [Mean±SD： （1.34±0.49）×109; Median： 1.25×109] correlated well with postprocessed TNC [Mean±SD： （1.21±0.42）×109; Median： 1.14×109; p0.001], CD34＋count [Mean±SD： （5.14±4.55）×106; Median： 4.08×106; p0.001] and CFU-GM content [Mean±SD： （9.72±8.66）×105;Median： 7.53×105; p0.001]. As for donor factors, only infant birth weight correlated strongly with volume collected and all hematopoietic cell parameters （p0.001）. UCB samples from bigger babies had higher collected volume, TNC, CD34＋ count and CFU-GM content （p0.001）. Mother＇s age had no correlation with all the above parameters. Gestational age correlated positively with initial/postprocessed TNC （p0.001） and negatively with CD34＋ count （p=0.04）, but no relation with collected volume and CFU-GM content. Cesarean section produced superior volume （Mean±SD： 97.05±22.23 ml vs 92.53±22.43 ml; Median： 94.08 ml vs 88.82 ml; p0.001）, but inferior cell count than vaginal delivery （p0.001）. Male infants had more initial volume and CD34＋ count （Mean±SD： 96.41±22.31 ml vs 93.95±22.47 ml; Median： 93.27 ml vs 90.14 ml; p0.001）; [Mean±SD： （5.28±5.04）×106 vs （5.00±3.94）×106; Medi
出处
《中国实验血液学杂志》
CAS
CSCD
2010年第6期1535-1541,共7页
Journal of Experimental Hematology
基金
广东省卫生厅科技项目(B2010274)
广州市医药卫生科技项目(2009-YB-078)基金资助
关键词
脐带血
造血干细胞
母体因素
新生儿因素
总有核细胞数
CD34+细胞
造血重建
umbilical cord blood
hematopoietic stem cell
maternal factor
neonatal factor
total nucleated cell
CD34＋ cell
hematopoietic reconstruction
