缺氧缺血性脑病足月新生儿外周血单个核细胞向神经细胞分化潜能的临床意义

Capability of peripheral mononuclear cells differentiating into neural cells in term infants with hypoxic ischemic encephalopathy

关键词:  缺氧缺血  脑  血细胞  神经细胞  足月  婴儿  新生

Key words:  hypoxia-ischemia  brain  blood cells  neurons  term birth  infant  newborn

摘要:

目的探讨缺氧缺血性脑病（hypoxic ischemic encephalopathy,HIE）足月新生儿外周血单个核细胞向神经细胞分化的潜能与临床表现的关系。方法50例足月新生儿,中度HIE和轻度HIE和对照各10例,重度HIE20例,其中2周后明显好转者10例,2周后无明显者10例。取出生后3 h内和第7天时（仍存活者）外周血单个核细胞体外诱导培养10 d,免疫组织化学法检测Nestin阳性表达细胞。结果新生儿外周血单个核细胞分化形成的具有神经细胞标志Nestin的细胞数,生后3 h重度HIE症状好转组（68.99±7.85）、症状无好转组（71.43±6.88）、中度HIE（73.34±6.46）、轻度HIE（70.46±6.66）,与对照组（71.13±7.19）相比,差异无统计学意义（F=0.382,P〉0.05）。生后第7天时,外周血单个核细胞分化为具有神经细胞标志Nestin的细胞数,重度HIE新生儿症状好转组明显增高（94.50±15.57 vs 68.99±7.85,t=4.657,P=0.000）,且高于同时期症状改善不明显组（94.50±15.57 vs 69.48±5.32,t=4.621,P=0.000）。结论重度HIE新生儿外周血单个核细胞向神经细胞分化潜能的高低与中枢症状改善有密切关系。

Abstract:

Objective To investigate the capability of peripheral mononuclear cells differentiating into neural cells in term infants with hypoxic ischemic encephalopathy （HIE）. Methods Blood samples were taken from 50 term infants within 3 h and 7 d after birth respectively, including newborns with severe HIE and improvement （n=10）, with severe HIE and no improvement （n=10）, with moderate HIE （n=10）, with mild HIE （n=10） and normal infants as controls （n=10）. The peripheral mononuclear cells were separated and cultured for 10 d and the induced Nestin positive cells were identified with immunohistochemistry. Results In 3 h after birth samples there were no difference in induced Nestin positive cells among the newborns with severe HIE and good improvement （68.99±7.85） ,with severe HIE and poor improvement （71.43±6.88 ）, with moderate HIE （73.34±6.46）,with mild HIE patients （70.46±6.66） and the controls （71.13±7.19,F=0.382, P〉0.05）. In newborns with severe HIE and improvement the induced Nestin positive cells in 7th day samples were significantly increased compared with that in 3 h samples （94.50±15.57 vs 68.99±7.85, t=4.657, P〈0.05 ）, and were higher than those in newborns with no improvement （94.50±15.57 vs 69.48±5.32, t=4.621, P〈0.05）. Conclusion The capability of peripheral mononuclear cells differentiating into neural cells is associated with clinical improvement in the term infants with severe HIE.