摘要
目的:探讨脐带间充质干细胞移植治疗早产儿支气管肺发育不良(BPD)的可行性、有效性和安全性。方法:选取孕周<32周、体质量<1 500 g、明确诊断为新生儿呼吸窘迫综合征(NRDS)并接受机械通气治疗的早产儿18例为研究对象,根据患儿家长意愿分为试验组8例和对照组10例。试验组患儿生后7 d、14 d分别给予气管内滴入脐带间充质干细胞1×107个/2 mL生理盐水,对照组仅给予同体积生理盐水,留取两组患儿生后7 d(移植前)、10 d(移植后3 d)、17 d(移植后10 d)、21 d(移植后14 d)、28 d(移植后21 d)的气道灌洗液以检测炎性因子水平,判断两组患儿于生后28 d BPD的发生情况,记录两组患儿用氧时间、住院时间、以及1岁内肺炎发生情况。结果:试验组患儿发生1例BPD,对照组患儿发生5例BPD;试验组患儿平均住院时间、平均用氧时间及1岁内肺炎发生频率分别为(43.5±3.0) d、(16.0±3.5) d及每人2.5次,对照组患儿平均住院时间、平均用氧时间及1岁内肺炎发生频率分别为(55.5±5.0) d、(23.5±7.5) d及每人4.2次;移植前,两组间与BPD发生密切相关的炎性因子(MIF、CD105、TGF-β1、IL-8)比较差异无统计学意义(P>0.05),但在移植后3 d、10 d、14 d、21 d试验组患儿肺泡灌洗液中抑制性炎性因子的水平均显著低于对照组,差异有统计学意义(P<0.05);移植前,两组间保护性炎性因子PLTP比较差异无统计学意义(P>0.05),但在移植后3 d、10 d、14 d、21 d试验组患儿显著高于对照组,差异有统计学意义(P<0.05)。结论:脐带间充质干细胞移植可通过降低炎性反应、促进保护性因子的分泌等机制防治早产儿BPD的发生,该方法安全有效、值得推广。
Objective:To investigate the feasibility,efficacy and safety of human umbilical cord blood-derived mesenchymal stem cell(h UCB-MSC) transplantation in the treatment of bronchopulmonary dysplasia(BPD) in premature infants.Methods:Eighteen premature infants with gestational age < 32 weeks and body mass < 1,500 g,who were definitely diagnosed as neonatal respiratory distress syndrome(NRDS) and received mechanical ventilation treatment,were selected as the research objects.According to the parents’ wishes,the infants were divided into the experimental group(n=8) and the control group(n=10).In the experimental group,1×107 cells/2 mL saline was instilled into the h UCB-MSC at 7 and 14 d after birth.The control group was given the same volume of normal saline alone.The airway lavage fluid of two groups after birth of 7 d(before transplantation),10 d(3 d after transplantation),17 d(10 d after transplantation),21 d(14 d after transplantation),and 28 d(21 d after transplantation) were collected to detect the inflammatory factor levels.The incidence of BPD in two groups after birth of 28 d was determined,and the oxygen consumption time,length of stay and incidence of pneumonia within 1 year old were recorded.Results:One patient developed BPD in the experimental group and 5 patients in the control group.The average length of stay,average oxygen consumption time and incidence of pneumonia within 1 year old in the experimental group were(43.5±3.0) d,(16.0±3.5) d and 2.5 times per patient.The average length of stay,average oxygen consumption time and incidence of pneumonia within 1 year old in the control group were(55.5±5.0) d,(23.5±7.5) d and 4.2 times per person.Before transplantation,the inflammatory factors(MIF,CD105,TGF-β1,IL-8) closely related to BPD were not significantly different between two groups(P>0.05),but the levels of inhibitory inflammatory factors in alveolar lavage fluid of experimental group were significantly lower than those of the control group at 3,10,14 and 21 d after transplantation(P<0.05).Bef
作者
王燕
姚国
耿晓萌
李桂芳
曹洋洋
刘俊丽
史宝海
Wang Yan;Yao Guo;Geng Xiaomeng;Li Guifang;Cao Yangyang;Liu Junli;Shi Baohai(Tai'an Central Hospital,Shangdong Tai'an 271000,China)
出处
《儿科药学杂志》
CAS
2019年第3期17-21,共5页
Journal of Pediatric Pharmacy
基金
山东省医药卫生科技发展计划
2013WS0059
关键词
脐带间充质干细胞
移植
早产儿支气管肺发育不良
防治
hUCB-derived MSC
transplantation
bronchopulmonary dysplasia
prevention and treatment
