影响脐带血采集质量的相关性因素分析

Analysis of factors associated with the quality of umbilical cord blood

目的回顾性分析影响脐带血采集质量的母婴因素和采集处理因素。方法记录389份脐带血的采集量、母亲年龄、孕龄、新生儿体重、分娩方式、新生儿性别、胎次及脐带血采集至计数间隔以及采集方式。用KX-21型全自动血液分析仪进行细胞计数并计算有核细胞总数(TNC)。采用Pearson相关和Spearman秩相关进行相关性分析,采用t检验、Mann-Whitney U检验、方差分析及Kruskal-Wallis H检验进行分组比较,分析影响脐带血采集量和TNC的相关因素。结果脐带血采集量与TNC显著相关(r=0.723,P <0.001),脐带血采集量大于80 ml时的TNC显著高于低体积者。在母婴因素中,母亲年龄与采集量及TNC差异均无统计学意义;孕龄与采集量负相关(r=-0.119,P=0.019),而与TNC正相关(r=0.138,P=0.007),足月儿脐带血的TNC显著高于早产儿(P=0.038);婴儿出生体重与采集量及TNC均正相关(r=0.236,P <0.001;r=0.275,P <0.001),体重较大婴儿脐带血的采集量和TNC均显著高于体重较小者(P <0.001);剖宫产的脐带血采集量虽高于阴道分娩(P <0.001),但其TNC不及阴道分娩;男婴与女婴在脐带血采集量和TNC之间无显著差异。在采集处理因素中,脐带血采集至计数的时间间隔与采集量及TNC均无显著相关。结论为提高脐带血的保存质量,应侧重选择胎儿体重较大、经阴道分娩的产妇作为脐带血供者,实验室应首先处理采集量较大的脐带血。

Objective To evaluate the maternal,infant and collection-processing factors associated with the quality of umbilical cord blood(UCB).Methods 389 umbilical cord blood units were recorded,including collection volume,mother's age,gestational age,infant birth weight,delivery way,sex of newborn,number of pregnancy,time interval between collection and counting and collection method.The total nucleated cells(TNC)were counted by KX-21 automatic blood analyzer.Pearson correlation and Spearman rank correlation were used for correlation analysis,t test,mann-whitney U test,variance analysis and kruskal-wallis H test were used for group comparison,and the correlation factors affecting umbilical cord blood collection volume and TNC were analyzed.Results There was a significant correlation between collection volume and TNC(r=0.723,P<0.001).As for maternal and infant factors,mother's age had no correlation between collection volume and TNC.Gestational age correlated negatively with collection volume(r=-0.119,P=0.019)and positively with TNC(r=0.138,P=0.007).The TNC from full-term infants was significantly higher than that of preterm ones(P=0.038).The infant birth weight correlated strongly with collection volume(r=0.236,P<0.001)and TNC(r=0.275,P<0.001).Although the collection volume of cesarean section was higher than that of vaginal delivery(P<0.001),its TNC was lower than that of vaginal delivery.There was no difference between male and female infants in collection volume and TNC.As for collection-processing factors,the time interval between collection and counting had no correlation between collection volume and TNC.Conclusion These results suggest that infant weight and vaginal delivery are associated with TNC.