影响脐血造血干细胞移植供体品质的相关因素分析

The effect of donor-related variables on cord blood donor product quality for cord blood hematopoietic stem cell transplantation

目的探讨影响脐血产品质量的供体相关因素，建立选择脐血移植供体的最优化标准。方法脐血采集自2000年6月至2006年12月在广州市妇婴医院足月分娩的产妇，分析脐血的总有核细胞数（TNC）、CD34^＋细胞数和总集落数（CFUs）与脐血供体相关因素（新生儿性别和体重、产妇年龄、孕周、分娩方式、胎粪污染、采集体积）的关系。结果TNC与CD34^＋细胞数、总集落数三者两两间均有相关性，TNC与CD45^＋细胞数相关性最好。TNC与新生儿体重、采集体积、产妇年龄有相关关系；阴道分娩、孕周〉40周和女性新生儿组TNC数分别高于剖宫产、36～40孕周和男性组。CD34^＋细胞数和总集落数与采集体积有相关关系，与新生儿体重、产妇年龄无相关关系。CD34^＋细胞数受分娩方式的影响（阴道分娩高于剖宫产），不同新生儿性别及孕周间差异无统计学意义。阴道分娩和男性组总集落数分别高于剖宫产和女性组，两组孕周间总集落数差异无统计学意义。采集体积与新生儿体重有关，与产妇年龄、分娩方式、新生儿性别、孕周无关。胎粪污染时TNC较高，CD45^＋细胞数、总集落数均无影响。结论孕周和新生儿体重指标增加到标准化的脐血采集前供体选择标准，将有利于获得更好的脐血采集质量、提高库存脐血的有效性。

Objective To study the effect of donor-related factors on cord blood product quality,in order to establish optimizing criteria for cord blood donors selection in cord blood transplantation. Methods Relation were analyzed between total nucleated cells （ TNC ） , CD34^＋ cells, total colony-forming cells （ CFCs ） and donor-related variables. The donor-related variables included newborn sex and weight, maternal age, gestational age, mode of delivery （vaginal or cesarean section） , presence or absence of meconium in amniotic fluid and collection volume. Results The significant correlation was found among TNC, CD34^＋ cell count and total CFCs count. The best correlation was found between TNC and CD34^＋ cell count. TNC had correlation with newborn weight, collection volume and maternal age. Vaginal delivery, greater than 40 weeks＂ gestational age and female newborn sex group had higher TNC count respectively than cesarean section,36 to 40 weeks＇gestational age and male newborn sex group. CD34^＋cell count and CFC count had correlation with collection volume and no eorrelation with newborn weight and maternal age. CD34^＋ cell count for vaginal delivery was higher than cesarean section, and had no statistic difference between different newborn sex or gestational age group. Total CFC count for vaginal delivery and male newborn sex group was higher respectively than cesarean section and female newborn sex group, and had no statistic difference between different gestational age. The collection volume was associated with newborn weight and was found to be unaffected by maternal age, mode of delivery, newborn sex and gestational age. Meconium presence in the amniotic fluid was associated with superior TNC and did not have affect on the CD34^＋ cell count and CFC count. Conclusion Gestationalage and newborn weight can be added to standard cord blood donor criteria in order to advance cord blood collection quality and improve the banked cord blood efficiency.