中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (28): 4572-4575.doi: 10.3969/j.issn.2095-4344.2015.28.026

• 干细胞移植 stem cell transplantation • 上一篇    下一篇

自体脐血单个核细胞回输早产儿：免疫功能及预后

杨春燕，许  平，李宝云，杨玉军，贾焕荣，周丽英，杨巧芝   

  1. 聊城市人民医院，山东省聊城市  252000
  • 出版日期:2015-07-02 发布日期:2015-07-02
  • 通讯作者: 许平，聊城市人民医院，山东省聊城市 252000
  • 作者简介:杨春燕，聊城市人民医院，山东省聊城市 252000

Autologous umbilical cord blood mononuclear cell transfusion in preterm children: immune function and prognosis

Yang Chun-yan, Xu Ping, Li Bao-yun, Yang Yu-jun, Jia Huan-rong, Zhou Li-ying, Yang Qiao-zhi   

  1. Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
  • Online:2015-07-02 Published:2015-07-02
  • Contact: Xu Ping, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
  • About author:Yang Chun-yan, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China

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摘要：

背景：脐血中富含造血干/祖细胞，有很强的增殖、分化及形成集落的能力，在刺激骨髓造血功能、提高血细胞活力和数量、促进免疫细胞发育成熟，维持机体免疫平衡等方面发挥重要作用。

目的：探讨自体脐血单个核细胞移植对早产儿免疫功能及预后的影响。
方法：选取2010年7月至2012年7月出生立即入住NICU病房，体质量≤ 1 500 g的早产儿62例，根据患儿家长自愿性原则分为治疗组和对照组；治疗组娩出后立即经脐静脉穿刺收集脐血，4 h内送中心实验室密度梯度离心后回输早产儿体内；治疗前后监测细胞免疫、体液免疫指标及相关临床指标。
结果与结论：治疗组治疗1周复查时细胞免疫指标CD4、CD4/CD8水平较前明显升高，较对照组比较差异有显著性意义(P=0.01，0.03)，而CD8变化不明显。治疗1周后两组早产儿的体液免疫指标IgM水平均较治疗前升高，但以对照组升高明显(P=0.00)；IgA水平改变不明显，IgG水平下降，以对照组下降明显(P=0.02)；住院期间，治疗组的重症感染发病率为13%，较对照组(16%)低，但差异无显著性意义；治疗组需机械通气患儿比例、平均住院时间与对照组比较差异有显著性意义(P < 0.05)。两组早产儿均随访至12个月，治疗组中反复呼吸道感染的发病人数为0例，而对照组为1例，两者比较差异有显著性意义(P < 0.05)。结果表明自体脐血干细胞移植有利于改善机体细胞免疫功能，减慢IgG下降水平，减少呼吸机的使用率，缩短住院时间，减低小婴儿的反复呼吸道感染的发病率。

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 干细胞, 移植, 早产儿, 细胞免疫, 体液免疫, 脐血移植, 造血干细胞

Abstract:

BACKGROUND: The umbilical cord blood is rich in hematopoietic stem/progenitor cells that have strong proliferation and differentiation ability as well as ability to form colonies, and exert important roles in stimulating bone marrow function, improving blood cell viability and quantity, promoting immune cell maturation, and maintaining immune balance.

OBJECTIVE: To evaluate the clinical effects of autologous umbilical cord blood mononuclear cell transplantation on the immunologic function and prognosis for premature infants.
METHODS: Sixty-two preterm infants who entered into NICU immediately after birth, weighing ≤ 1 500 g, were divided into treatment group and control group according to parent’s willingness. In the treatment group, the umbilical cord blood was extracted from the umbilical vein and re-infused into the preterm infants after density gradient centrifugation within 4 hours. The cellular immunity levels, humoral immunity levels and clinical parameters were monitored before and after treatment.
RESULTS AND CONCLUSION: After 1 week of treatment, the CD4, CD4/CD8 levels were significantly increased compared with the control group (P=0.01, 0.03), but CD8 level had no changes. At 1 week after treatment, IgM levels were both increased in the two groups, especially in the control group (P=0.00); IgA levels had no changes; IgG levels were decreased, especially in the control group (P=0.02). The incidence of severe infection during hospitalization was 13% in the treatment group, which was lower than the control group (16%), but there was no difference between the two groups. The proportion of infants undergoing mechanical ventilation and average length of stay had significant differences between the two groups (P < 0.05). After 12 months, the incidence of recurrent respiratory tract infections was zero in the treatment group and one case in the control group, and there was a significant difference between the two groups. These findings indicate that autologous umbilical cord blood mononuclear cell transplantation can improve the immunologic function, slower the reduction of IgG levels, reduce the usage of breathing machine, shorten the length of stay, and reduce the incidence of recurrent respiratory tract infections in preterm infants.

Key words: 干细胞, 移植, 早产儿, 细胞免疫, 体液免疫, 脐血移植, 造血干细胞

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