促红细胞生成素治疗缺氧缺血性脑病新生儿的药代动力学变化  

Changes of Pharmacokinetics of Erythropoietin in Neonate with Hypoxic-Ischemic Encephalopathy

作　　者：康文清[1] 朱长连[2] 熊虹[1] 贾莉婷[2] 刘东[1] 王小阳[2] 

机构地区：[1]郑州市儿童医院新生儿科,郑州450053 [2]郑州大学第三附属医院儿科,郑州450052

出　　处：《实用儿科临床杂志》2007年第8期622-623,共2页Journal of Applied Clinical Pediatrics

基　　金：河南省医药卫生创新人才基金项目资助(2004107048)

摘　　要：目的通过测定缺氧缺血性脑病(HIE)新生儿用药前后血清、脑脊液(CSF)促红细胞生成素(EPO)水平,探讨EPO的药代动力学变化及透过患儿血脑脊液屏障的情况。方法对35例48 h内收入院的中、重度HIE患儿随机分为用药前组10例,观察组25例。入院后观察组立即予重组人促红细胞生成素(rhEPO)500 U/kg皮下注射。其中用药后3 h组10例,8 h组8例,24 h组7例。用药前组在常规治疗前,观察组在给予EPO后的各时间点分别抽取静脉血、CSF,采用放射免疫法测定血清、CSF中EPO水平。结果观察组血清EPO水平3 h达峰值,是用药前的2.6倍(P<0.01),用药后24 h仍高于用药前水平,但无显著性差异。CSF中EPO水平也在用药后3 h达高峰(P<0.05),但在用药后8 h回落至用药前水平。观察组用药后3 h血清与CSF中EPO水平呈直线相关(r=0.69 P<0.05),而其他组间未发现相关性。结论EPO能通过HIE患儿的血脑脊液屏障,CSF中EPO水平与血液EPO水平有关。Objective To explore the pharmacokinetics and possibility to pass through the blood brain barrier of the recombinant human erythropoietin （ EPO ） in neonate with hypoxic - ischemic encephalopathy （HIE） by measuring the erythropoietin concentration in blood and cerebrespinal fluid （CSF）. Methods Moderate and severe HIE infants were randomized to pre - treatment group （ n = 10 ） and treatment group of 3 h （n = 10）, 8 h （n =8） and 24 h （n =7）after a single subcutaneous EPO administration with a dose ofS00 U/kg, The EPO concentration in blood and CSF were measured by imunoradioassay. Results The EPO concentration in blood reached peak at 3 h after treatment, which was 2.6 times higher than that in before treatment patients（ P 〈0. 01 ）. It decreased after that and still kept high level at 24 h after EPO administration even though no significant differentce. The EPO concentration in CSF had a similar tendency with that in blood and reached peak at 3 h post EPO injection, which was significantly higher than that in patients of before treatment（P 〈0.05 ）, but it recovered at 8 h. Regression analysis showed that EPO concentration in blood and CSF was positively correlated at 3 h after EPO administration （ r = 0. 69 P 〈 0. 05 ）. But other groups had no correlations. Conclusions EPO can pass through the blood brain barrier in HIE infants. The EPO concentration in CSF is eorrelatod with EPO concentration in blood.

关 键 词：促红细胞生成素类 婴儿 新生 窒息 缺氧缺血 脑 

分 类 号：R722.1[医药卫生—儿科]