高压氧对外周血造血干细胞数量影响的临床观察及实验研究

Effect of hyperbaric oxygen on number of peripheral blood stem cells:clinical observation and experimental study

目的:探讨高压氧对国人的外周血造血干细胞的影响,并通过动物实验尝试高压氧联合集落刺激因子动员外周血造血干细胞的方法。方法:(1)在常规的高压氧治疗方案下,观察了8例长期接受高压氧治疗的患者以及18例因神经系统损伤而接受高压氧治疗的患者在高压氧治疗前后其外周血CD34+细胞绝对计数的变化情况。(2)将30只BALB/c小鼠随机分成3组,每组10只。高压氧组(HBO组)接受高压氧暴露的处理;造血生长因子组(HGF组)接受注射重组造血生长因子的处理;高压氧联合造血生长因子组(HBO+HGF组)接受高压氧暴露联合注射重组造血生长因子的处理。在处理前后分别采集球后静脉血,以流式细胞仪检测设门细胞中CD34+/Scal-1+细胞的百分比。结果:(1)18例因神经系统损伤而接受高压氧治疗的患者经过7次高压氧治疗,外周血CD34+细胞绝对计数由接受高压氧治疗前的(1.87±1.08)×106/L升高到(4.75±4.67)×106/L;而经过14次高压氧治疗,患者外周血CD34+细胞绝对计数为(2.85±1.94)×106/L;经过20次高压氧治疗,患者外周血CD34+细胞绝对计数为(3.26±3.49)×106/L。8例长期接受高压氧治疗的患者其外周血CD34+细胞绝对计数为(2.11±1.14)×106/L,与18例神经系统损伤患者未接受高压氧治疗前相比没有统计学差异。(2)HBO组、HGF组和HBO+HGF组小鼠动员后设门细胞中CD34+/Scal-1+细胞的百分比分别是动员前的2.01倍、2.66倍和3.76倍。结论:高压氧治疗可以动员外周血造血干细胞,但长期高压氧暴露不能使外周血CD34+细胞绝对计数保持在较高水平。高压氧联合造血生长因子能够更加有效地动员外周血造血干细胞。

Objective：To observe the effect of hyperbaric oxygen （HBO） on peripheral hematopoietic stem cells （PHSCs） in a Chinese population, and to mobilize PHSCs by combined use of HBO and colony-stimulating factor （CSF） in an animal experiment. Methods： （1） The changes of CD34^＋ absolute count before and after HBO therapy were observed under routine HBO conditions in 8 patients who received long-term HBO therapy and 18 patients who received HBO therapy for neurological injuries. （2） Thirty BALB/c mice were equally randomized into three groups： HBO group, where the animals were exposed to HBO; HGF group, where the animals received recombinant hematopoietic growth factor injection; and HBO＋ HGF group. Postglobe venous blood was harvested before and after treatment; the gated cell CD34/Scal-1 dual-positive population was determined by flow cytometry. Results： （1） After 7 episodes of HBO therapies, the peripheral CD34^＋ absolute count of the patients rose from （1.87±1.08） 〉（106/L before treatment to （4.75±4.67） ×10^6/L（an increase of 2.54 folds）; while the number was（2.85±1.94） ×10^6/L after 14 episodes of HBO therapies （with an increase of 1. 52 folds） and （3. 26±3.49） ×10^6/L after 20 episodes of HBO therapies （with a increase of 1. 74 folds） . The peripheral CD34^＋ absolute count of the 8 patients who received long-term HBO therapy for neurological injuries was （2. 11±1. 14）×10^6/L, not significantly different from that of the 18 patients before treatment. （2） The gated cell CD34/Scal-1 dual-positive population in HBO group, HGFgroup, and HBO＋HGF group after treatment were 2.01, 2.66. and 3. 76 folds before treatment, respectively. Conclusion： Multiple HBO exposure can mobilize PHSC; prolonged HBO exposure fails to maintain the peripheral CD34^＋ absolute count at a relatively high level. Concomitant use of HBO and HFG can more effectively mobilize PHSCs.