标准化脐血筛选方法在脐血库中的应用  

The application of cord blood standardized screening methods in cord blood bank

作　　者：许遵鹏[1] 廖灿[1] 陈劲松[1] 吴洁莹[1] 辜少玲[1] 钟惠珠[1] 黎丽仙[1] 

机构地区：[1]广州市妇婴医院广州脐血库,510180

出　　处：《中国小儿血液与肿瘤杂志》2006年第1期1-5,11,共6页Journal of China Pediatric Blood and Cancer

基　　金：广东省科委;广州市科委;省卫生厅"五个一工程"重点课题(No96-Z-64-1和99-Z-008-01)

摘　　要：目的对广州脐血库脐血筛选结果进行回顾性分析,建立脐血筛选的标准化方法和探讨其在脐血库建立中的意义。方法对脐血供者从产妇或其旁系亲属医学病史到新生儿随访实行四步筛选程序,筛选内容包括遗传、血液病等病史、脐血采集量、总有核细胞数、细胞活率、凝块和病原学感染等。结果1998年6月至2004年12月共分娩27404例、采集脐血8350份,占总分娩量比率为30.47%。合格4085份,合格率为48.92%;废弃脐血4265份(占51.08%),废弃的主要原因依次为脐血采集量<60ml、血凝块、总有核细胞数、活率低。检疫期共废弃脐血46份(占1.11%);其中检出细菌阳性19例(占41.30%),巨细胞病毒抗体(CMV-lgM)阳性20例(占43.48%)。新生儿随访共发现15例异常,占0.37%。4085份脐血总有核细胞数平均为1.21×109,根据脐血有核细胞输入量3.7×107/kg体重计算,平均能适合32.7kg的受者移植;而按2.0×107/kg体重计算平均能适合60.5kg的受者移植。104例脐血移植中72例获得植入(69.2%)。结论脐血供者的标准化筛选方法可以排除可能存在的血液性、遗传性和传染性等疾病,确保移植用脐血的安全;并能为脐血库的建立节约采集、处理、冻存等费用,提高库存脐血的有效利用率。Objective In order to discuss the establishment and significance of cord blood screening standardized methods in cord blood bank, the result of cord blood donor screening in Guangzhou cord blood bank were analyzed retrospectively. Methods Cord blood donors were screened by four - step screening procedure from mother and her family medical history to follow - up of infants. The procedure includes the medical history of inherited diseases and hematological diseases, cord blood collected volume, total nucleated cells（TNC） ,cell viability, blood clot,pathogenic infection and so on. Results 8350 units（30.47% ） of cord blood were collected in 27404 births from June 1998 to Dec 2004. Among 8350 UCB collected,4085 units were qualified（48.92% ） ;4265 units（S1.08% ） were discarded,mainly due to low collected volume, clot, low nucleated cells and low cell viability, In quarantine ,46 units of cord blood（ 1.11% ） were discarded, the most factors were germiculture positive and cytomegalovirus positive. 15 cases（0.37% ） were ab- normal in infants follow - up. The average nucleated cells of 4085 units of frozen cord blood were 1.21 × 10^9 and the average recipient weight of available transplantation is 32.7kg and 60.5kg respectively according to the recommended number of TNC for UCB transplantation is 3.7 × 10^7/kg and 2.0 × 10^7/kg. 72 of 104 cases of transplantation were engrafted（69.2% ）. Conclusion Standardized donor screening project can exclude the possibility of hematological, inherited and infective diseases and insure the safety of cord blood for transplantation. It is important to improve the bank efficiency.

关 键 词：脐血库 供体筛选 标准 

分 类 号：R446.6[医药卫生—诊断学]