| 摘要: |
| 目的:探讨脐带间充质干细胞移植治疗早产儿支气管肺发育不良(BPD) 的可行性、有效性和安全性。方法:选取孕周<32 周、体质量<1 500 g、明确诊断为新生儿呼吸窘迫综合征(NRDS)并接受机械通气治疗的早产儿18 例为研究对象,根据患儿家长意愿分为试验组8 例和对照组10 例。试验组患儿生后7 d、14 d 分别给予气管内滴入脐带间充质干细胞1×10^7 个/2 mL 生理盐水,对照组仅给予同体积生理盐水,留取两组患儿生后7 d(移植前)、10 d(移植后3 d)、17 d(移植后10 d)、21 d(移植后14 d)、28 d(移植后21 d)的气道灌洗液以检测炎性因子水平,判断两组患儿于生后28 d BPD 的发生情况,记录两组患儿用氧时间、住院时间、以及1 岁内肺炎发生情况。结果:试验组患儿发生1 例BPD,对照组患儿发生5 例BPD;试验组患儿平均住院时间、平均用
氧时间及1 岁内肺炎发生频率分别为(43.5±3.0)d、(16.0±3.5) d 及每人2.5 次,对照组患儿平均住院时间、平均用氧时间及1 岁内肺炎发生频率分别为(55.5±5.0)d、(23.5±7.5)d 及每人4.2 次;移植前,两组间与BPD 发生密切相关的炎性因子(MIF、CD105、TGF-β1、IL-8)比较差异无统计学意义(P>0.05),但在移植后3 d、10 d、14 d、21 d 试验组患儿肺泡灌洗液中抑制性炎性因子的水平均显著低于对照组,差异有统计学意义( P<0.05);移植前,两组间保护性炎性因子PLTP 比较差异无统计学意义(P>0.05),但在移植后3 d、10 d、14 d、21 d 试验组患儿显著高于对照组,差异有统计学意义(P<0.05)。结论:脐带间充质干细胞移植可通过降低炎性反应、促进保护性因子的分泌等机制防治早产儿BPD 的发生,该方法安全有效、值得推广。 |
| 关键词: 脐带间充质干细胞 移植 早产儿支气管肺发育不良 防治 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2019.03.006 |
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| 基金项目:山东省医药卫生科技发展计划,2013WS0059 |
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| Human Umbilical Cord Blood-Derived Mesenchymal Stem Cell Transplantation in the Prevention and Treatment of Bronchopulmonary Dysplasia in Premature Infants |
| Wang Yan, Yao Guo, Geng Xiaomeng, Li Guifang, Cao Yangyang, Liu Junli, Shi Baohai |
| (Tai'an Central Hospital,Shangdong Tai'an 271000, China) |
| Abstract: |
| Objective: To investigate the feasibility, efficacy and safety of human umbilical cord blood-derived mesenchymal stem cell
(hUCB-MSC) transplantation in the treatment of bronchopulmonary dysplasia ( BPD) in premature infants. Methods: Eighteen
premature infants with gestational age < 32 weeks and body mass < 1,500 g, who were definitely diagnosed as neonatal respiratory
distress syndrome (NRDS) and received mechanical ventilation treatment, were selected as the research objects. According to the
parents'wishes, the infants were divided into the experimental group (n = 8) and the control group (n = 10). In the experimental
group, 1伊107 cells/2 mL saline was instilled into the hUCB-MSC at 7 and 14 d after birth. The control group was given the same volume of normal saline alone. The airway lavage fluid of two groups after birth of 7 d ( before transplantation), 10 d (3 d after
transplantation), 17 d (10 d after transplantation), 21 d (14 d after transplantation), and 28 d (21 d after transplantation) were
collected to detect the inflammatory factor levels. The incidence of BPD in two groups after birth of 28 d was determined, and the oxygen consumption time, length of stay and incidence of pneumonia within 1 year old were recorded. Results: One patient developed BPD in the experimental group and 5 patients in the control group. The average length of stay, average oxygen consumption time and incidence of pneumonia within 1 year old in the experimental group were (43.5±3.0) d, (16.0±3.5) d and 2.5 times per patient. The average length of stay, average oxygen consumption time and incidence of pneumonia within 1 year old in the control group were (55.5±5.0) d,(23.5±7.5) d and 4.2 times per person. Before transplantation, the inflammatory factors (MIF, CD105, TGF-β1, IL-8) closely related to BPD were not significantly different between two groups (P>0.05), but the levels of inhibitory inflammatory factors in alveolar lavage fluid of experimental group were significantly lower than those of the control group at 3, 10, 14 and 21 d after transplantation (P<0.05).Before transplantation, there was no significant difference in protective inflammatory factors PLTP between two groups (P>0.05), but the experimental group were significantly higher than the control group at 3, 10, 14 and 21 d after transplantation, with statistically significant difference (P < 0. 05). Conclusion: The hUCB-MSC transplantation can prevent and treat BPD in premature infants by reducing inflammatory response and promoting secretion of protective factors. This method is safe, effective and worthy of promotion. |
| Key words: hUCB-derived MSC transplantation bronchopulmonary dysplasia prevention and treatment |
