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脐带血随储存时间红细胞损伤变化与微生物安全性评估
Evaluation of Red Blood Cell Damage and Microbiological Safety of Whole Cord Blood during Storage
【摘要】 目的 评估脐带血(UCB)在柠檬酸磷酸葡萄糖腺嘌呤(CPDA-1)保存液中于2~6??℃条件下储存35??d内的红细胞稳定性与微生物安全性,为其在新生儿心脏手术等临床场景中的预存式自体输血应用提供实验依据。方法 在先天性心脏病产前产后一体化诊疗模式下,采集60例产前诊断为先心病新生儿的UCB样本。将样本随机分为5组,分别在储存7、14、21、28、35??d后,检测其血常规、电解质、游离血红蛋白、溶血率及微生物污染情况。结果 储存前各组基线数据无显著差异。储存期间,红细胞计数、血红蛋白、血细胞比容、血小板及钠、钙离子浓度未见显著变化。血钾、游离血红蛋白和溶血率均随储存时间延长而显著升高(P<0.05)。事后检验显示,血钾从第7天起持续显著上升,游离血红蛋白与溶血率则在储存21??d后开始显著增加。所有样本中1例(1.7%)发生大肠埃希菌污染。结论 在标准化采集与储存流程下,UCB在CPDA-1保存液中储存35??d内,尽管存在进行性的钾离子积累和溶血加剧,但其关键质量指标仍在可接受范围内,且微生物安全性可控。本研究支持脐带血可作为新生儿,特别是需限期手术的先天性心脏病患儿,一种安全、可行的自体血源。
【Abstract】 Objective To evaluate the red blood cell stability and microbiological safety of umbilical cord blood (UCB) stored in citrate phosphate dextrose adenine-1 (CPDA-1) anticoagulant preservative solution at 2~6??℃ for up to 35??days,providing experimental evidence for its use in predeposit autologous transfusion during neonatal cardiac surgery and other clinical scenarios.Methods Within an integrated prenatal–postnatal diagnosis and treatment model for congenital heart disease,UCB samples were collected from 60 neonates prenatally diagnosed with CHD.The samples were randomly divided into five groups.After storage for 7,14,21,28,and 35??days,routine blood counts,electrolytes,free hemoglobin,hemolysis rate,and microbial contamination were measured.Results There were no significant baseline differences among groups before storage.During storage,red blood cell count,hemoglobin,hematocrit,platelet count,and sodium and calcium ion concentrations showed no significant changes.Potassium,free hemoglobin,and hemolysis rate all increased significantly with prolonged storage time (P<0.05).Post-hoc analysis revealed that potassium level rose steadily from day 7 onwards,while free hemoglobin and hemolysis rate increased significantly after 21??days of storage.Bacterial contamination with Escherichia coli occurred in 1 case (1.7%) among all samples.Conclusion Under standardized collection and storage protocols,UCB stored in CPDA-1 anticoagulant preservative solution for up to 35??days showed progressive potassium accumulation and hemolysis,yet key quality indicators remained within acceptable ranges and microbiological safety was controllable.This study supports that UCB represents a safe and feasible autologous blood source for neonates,particularly those with congenital heart disease requiring time-limited surgery.
【Key words】 Umbilical cord blood; CPDA-1 anticoagulant preservative solution; Predeposit autologous transfusion; Hemolysis rate;
- 【文献出处】 临床输血与检验 ,Journal of Clinical Transfusion and Laboratory Medicine , 编辑部邮箱 ,2026年02期
- 【分类号】R457.1
- 【下载频次】9