脐带血有必要保存吗

脐带血有必要保存吗 脐带血是胎儿娩出、脐带结扎并离断后残留在胎盘和脐带中的血液，通常是废弃不用的。近十几年的研究发现，脐带血中含有可以重建人体造血和免疫系统的造血干细胞，可用于造血干细胞移植，治疗80多种疾病。因此，脐带血已成为造血干细胞的重要来源，特别是无血缘关系造血干细胞的来源。也是一种非常重要的人类生物资源。[1] 脐带血作用 脐带血中含有大量的干细胞，干细胞是生命的种子，它会分化成人体的各种细胞，结出各种不同的果实——血液细胞，神经细胞，骨骼细胞等等。随着科技的发达，医学专家研究出利用脐带血中的干细胞来治疗疾病的方法。 干细胞是具有自我更新、高度增殖和多项分化潜能的细胞群体。这些细胞可以通过分裂维持自身细胞的特性和数量，又可进一步分化为各种组织细胞，从而在组织修复等方面发挥积极作用。 近三十年来的医学研究发现，脐带血中含有非常丰富的造血干细胞(HSC)，可以重建人体造血和免疫系统，可用于造血干细胞移植，治疗血液系统、免疫系统，以及遗传代谢性及先天性疾病。因此，脐带血已成为造血干细胞的重要来源，已经被广泛地应用于临床，是宝贵的人类生物资源。 脐带血临床应用案例 世界首例脐血移植:1988年，一名5岁的法国男孩，用脐带血成功治愈了范科尼贫血。(脐血来源:美国) 世界首例自体脐血移植:1997年，一名14个月的巴西女童，用自体脐带血成功治愈了神经母细胞瘤。(脐血来源:巴西) 世界首例双份脐血移植:2000年，北京大学血液病研究所，世界首例双份脐带血移植治疗急性淋巴细胞白血病获得成功，患者体重达95公斤，目前仍然健康生活。(脐血来源:北京市脐血库) 亚洲首例自体脐血移植:2009年，北京儿童医院，一位小患者使用自己的脐带血治疗神经母细胞瘤，这也是我国第一例使用自体脐带血治疗成功的病例，小患者移植后健康状况良好。(脐血来源:北京市脐血库) application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 国内患者年龄最小体重最轻:2009年，上海道培医院，我国体重最小——5公斤，同时也是年龄最小——2个月的小患者，使用脐带血移植治疗原发性免疫缺陷病宣告成功。(脐血来源:北京市脐血库) 国内第一例母子间脐血移植:2009年，重庆新桥医院，一名急性非淋巴细胞白血病的患者，使用刚出生儿子的脐带血加上其父亲的骨髓进行移植。移植一个月后离开层流病房，造血系统重建，这是我国第一例母子间脐血移植的案例。(脐血来源:北京市脐血库) 脐带血储存的意义 治愈疾病 世界范围内，目前脐血已经用于治疗各种类型白血病、再生障碍性贫血、淋巴瘤、多发性骨髓瘤、神经母细胞瘤、粘多糖病、地中海贫血、骨髓发育不良症候群、原发性免疫缺陷病、慢性肉芽肿等80多种疾病。 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 我国卫生部颁发的《脐带血造血干细胞治疗技术管理规范(试行)》中规定，脐带血造血干细胞治疗技术适应症包括以下10余类: 截止到2013 年，中国脐血移植例数超过1000 例，脐带血移植数量逐年增加，每年移植数量约为150 例，但与世界领先地区相比，中国脐血移植处于起步阶段。随着脐带血存储量的增加，移植技术的成熟，中国脐带血移植会逐步向着国际水平靠近。 截至目前，北京市脐血库向临床提供脐带血治疗白血病、淋巴瘤、再生障碍性贫血、噬血细胞综合征、慢性肉芽肿、戈谢病、神经母细胞瘤等疾病种类37种。 治疗前景 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check Clinical Trials临床试验 21世纪是生物的世纪，细胞治疗作为一种生物治疗手段，为人类疾病的治疗打开了全 新的思路。截止2014年5月底，全球已在美国国立卫生院(NIH)注册与脐带血相关的临 床研究共928项。 自体免疫疾病: 类风湿关节炎 红斑狼疮 多发性硬化症 心脑血管疾病: 先天性心脏病 心脏修复和恢复 缺血性中风 神经性疾病: 脑性麻痹 缺氧缺血性脑病 自闭症 创伤性脑损伤 脊髓损伤 听力损失 肌萎缩性脊髓侧索硬化症 阿尔茨海默氏病(老年痴呆) 恶性疾病: application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 乳癌 肾癌 先天性疾病: 杜氏肌营养不良症 Becker型肌营养不良 囊性纤维化 其他疾病: 1型糖尿病 艾滋病 软骨修复 重症肢体缺血 一人储存 全家受益 脐带血在家族有血缘关系的亲属中的使用率是25%—50%，加大了在自身家族中找到 供者的几率。 脐带血采集 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 脐血采集不同于传统的骨髓采集，不需要进行麻醉，无痛、无副作用，是在断脐以后进行的，因此对母亲和孩子没有任何不良影响，属于“废物利用，变废为宝”。 采集需由具有专业资质的医护人员完成，在婴儿出生后，使用含有抗凝剂的密封式血袋收集脐血。 采集人员必须是具有执业资质并注册的医生或护士，且经过脐带血采集的培训。 脐带血储存 1、孕妇分娩前联系当地脐带血保存机构 2、签订《捐献脐带血造血干细胞意向书》/《脐带血造血干细胞储存书》，领取脐带血采集器具 3、孕妇分娩时，由医护人员采集脐带血 4、孕妇分娩后立刻打电话通知脐血库，成功采集的脐带血会由专业的取血员，驾驶专用的取血车，在24小时内将脐血运输到脐血库 5、脐血库采用最先进的设备，对脐带血进行制备和多项检测 6、检测合格的脐带血，最终存放在-196?C的液氮罐中，保证脐带血的活性 7、客户在婴儿出生后的60个工作日内，会收到“脐带血检测书” 脐带血发展史 脐带血发展历史 自20世纪80年代初美国科学家首次提出将脐带血用于干细胞移植的概念后，曾经被视作废物丢弃的“脐带血”随即变废为宝，震惊世界。 1972年，1名急性淋巴细胞白血病患者输注脐血后发现短暂嵌合; 1974年，Knudtzon等发现脐带血干细胞可以经过冷冻保存而不影响活性和增值潜能，可作为造血干细胞移植供源; 1988年，Broxmeyer等系统的评估了脐血体外造血潜能，为脐血大规模存储及广泛应用奠定理论基础; application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 1988年， 法国巴黎圣路易医院对1名范可尼贫血患儿进行HLA相合的同胞脐带血移植获得成功; 1992年，全球第一家公共脐血库在纽约血液中心成立; 1993年，全球第一例无关供者儿童脐血移植完成; 2000年， Eurocord/IBMTR 113例儿童同胞脐血移植报道; 2001年, Eurocord/EBMT 99例儿童非血缘脐血移植报道; 2003年，明尼苏达大学43例低预处理强度成人脐带血移植报道; 2004年， Eurocord/EBMT 98例成人非血缘脐血移植报道 IBMTR/NYBC 150例成人非血缘脐血移植报道 全球第一例自体脐血移植治疗白血病在美国完成; 2005年，明尼苏达大学23例双份UCBT报道。 脐带血移植自第一例发展至今已经经历了20多年，全世界以脐带血来源的造血干细胞进行移植的临床案例逐年增加，至2002年约2000例，随后呈指数性增加，最新数据显示，全世界范围内脐血移植的病例已经累计38000例以上。 21世纪，细胞治疗作为一种生物治疗手段，为人类疾病的治疗打开了全新的思路。截止2014年5月底，全球已在美国国立卫生院(NIH)注册与脐带血相关的临床研究共928项。 在我国，脐血治疗已被卫生部列入“首批允许临床应用的第三类医疗技术目录”。为了挖掘脐带血的医学价值，推动脐带血应用在我国的发展，北京市脐血库成立研发中心，主要负责脐血医疗价值的研发及现有制备储存技术的优化，与科研单位共同研制和发展新技术和新产品。 目前已与北京大学人民医院、军事医学科学院野战输血研究所、中国科学院生物物理研究所、中国医学科学院实验动物研究所、中国医学科学院组织工程研究中心，北京妇产医院、首都医科大学附属友谊医院、北京武警总医院等多个机构建立了密切的科研合作关系，在神经系统、血液系统、妇产医学、肝病等领域开展了深入的合作，并参与多项国家科研项目的申请和研究。 脐带血法律法规 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 根据卫生部文件《脐带血造血干细胞库管理》(试行)的通知，脐带血造血干细胞库的设置必须经国务院卫生行政部门批准。未取得脐带血造血干细胞库执业许可证的单位和个人，一律不得开展采供脐带血造血干细胞业务。临床应用单位只能接受具有执业许可证的脐带血造血干细胞库提供的脐带血。 根据卫生部文件《脐带血造血干细胞库技术规范(试行)》(卫办医发【2002】80号)中对脐带血的采集有详细要求，并明确规定“采集医疗机构的工作人员必须受过脐带血采集培训”。北京市卫生局《关于加强脐带血造血干细胞临床采集管理的通知》(京卫医字【2008】198号)又对加强脐带血采集管理和提高脐带血采集质量做了进一步细化规定，明确提出“脐带血库负责组织实施脐带血采集技术的培训和考核”。 脐带血储存的机构 目前，我国卫生部批准执业的七家脐带血库包括:北京市脐带血造血干细胞库、天津市脐带血造血干细胞库、上海市脐带血造血干细胞库、山东省脐带血造血干细胞库、广东省脐带血造血干细胞库、浙江省脐带血造血干细胞库、四川省脐带血造血干细胞库。 同时，卫生部规定每个省市只能建立一家脐带血库，不能异地采集脐带血，准妈妈若要储存或捐献脐带血，一定要查看脐带血库的资质，是否具有当地卫生局颁发的《血站执业许可证》。 北京市脐血库成功通过美国血库协会AABB认证，成为中国七家由卫生部批准执业的脐带血库中首家获此殊荣的脐带血库。 AABB认证的宗旨在于推动和全面保障脐带血质量的提升，以更好满足脐血储存家庭和临床医生所需的高品质医疗需求，促使脐带血相关服务严格遵循国际标准，以获得妥善的处理和储存，最大程度的保证脐血储存家庭的利益以及临床用血的安全性。 AABB认证源自于美国血库协会(American Association of Blood Banks，简称AABB)，该组织创建于1947年，是专注于输血医学与相关细胞治疗实践及科学进步的非盈利性国际组织。长期以来，AABB通过制定和发布质量与技术标准、提供认证与教育服务，致力于提升患者和供者的治疗与安全，是国际输血界行业规范的制定者和行业认证的权威机构。 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check