母亲、新生儿和收集相关因素对高质量脐血的影响

目的:探讨母亲、新生儿和收集相关因素对高质量脐血(high-quality cord blood units,HQCBUs)的影响。方法:用logistical回归模型回顾性分析广州脐血库(Guangzhou Cord Blood Bank,GZCBB)库存的4613例脐血的母亲、新生儿和收集相关因素,所有脐血均严格按照操作规程进行供者选择、采集、运送、处理、检测和冻存。结果:影响HQCBUs的因素包括分娩时顺产、孕周大于37周、新生儿为女性、较重的体重(3500 g)、脐血体积大(80 m L)、运送耗时短(12 hr)。α-地贫携带者对处理后细胞数(postprocessing total nucleated cell count,p-TNCC)1.25×109和CD34+细胞数6.01×106有影响,而羊水粪染和母亲分娩年龄小于25岁分别对p-TNCC1.25×109和细胞集落形成单位(colony forming units,CFUs)23.24×105有影响。结论:我们鉴定出影响HQCBUs的因素,为GZCBB更新脐血采集标准、优化处理程序提供参考依据,有助于提高HQCBUs的数量和比例及有效利用脐血库的资源。

Influence of Maternal, Infant, and Collection Characteristics on High-qualityCord Blood Units in Guangzhou Cord Blood Bank

Objective:To investigate the influence of maternal, infant, and collection characteristics on HQCBUs in GZCBB.Methods:The maternal, fetal, and processing conditions of 4613 CBUs in the GZCBB were retrospectively analyzed to determine theireffects on HQCBUs using logistical regression model. All CBUs were obtained following strict standard operating procedures.Results:Several factors might contribute to HQCBUs: fetal age older than 37 gestational weeks, female fetus, large cord blood volume (>80 mL),high birth weight (>3500 g), vaginal delivery, and a shorter amount of time between cord blood collection and processing (<12 hr). Wereported here for the first time that alpha-thalassemia carriers correlated with a p-TNCC increase to at least 1.25× 109 and an increase ofCD34+ cell count to at least 6.01× 106. Meconium-stained amniotic fluid and mothers younger than 25 years of age increased theirp-TNCC to at least 1.25 × 109 and the CFUs increased to at least 23.24 × 105.Conclusion:We identified several factors that affectHQCBUs. These results may be used as a reference for updating cord blood collection standards and optimizing processing proceduresand will help to increase the number and ratio of HQCBUs and the effective use of CBB resources.