不同剂量促红细胞生成素治疗新生儿缺氧缺血性脑病的疗效比较  

Neuroprotective effect of the different dosage of recombinant human erythropoietin on neonatal hypoxia ischemia encephalopathy

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

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

出　　处：《河南医学研究》2007年第2期132-135,共4页Henan Medical Research

摘　　要：目的:观察不同剂量促红细胞生成素(erythropoietin,EPO)治疗新生儿缺氧缺血性脑病的早期疗效及安全性。方法:将76例患儿随机分为三组,小剂量EPO组29例,rhEPO 300 U/kg.次,大剂量EPO组23例,rhEPO 500 U/kg/次,首次皮下注射,以后静脉注射,每周3次,连续2周;其余治疗措施同对照组24例。三组患儿在治疗前、后监测血压、肝、肾功能、电解质、Hb、Ret及P lat的变化,同时在生后3 d、5 d、7 d进行神经学评分,生后7 d、14 d、28 d进行新生儿神经行为评分。结果:①新生儿神经行为评分三组之间差异有统计学意义(P<0.01),大、小剂量组均显著高于对照组(P<0.01),而大、小剂量组之间无差异(P>0.05);②神经学评分随时间改变,组别之间差异有统计学意义;在第7天,大、小剂量组分别与对照组之间差异有显著性(P<0.05);而大、小剂量组之间无统计学差异(P>0.05)。③EPO治疗两周后除Hb、Ret显著高于对照组外,其它监测指标如肝、肾功能、电解质、血压、血糖及p lat均无统计学差异(P>0.05)。结论:300或500 U/kg.次EPO都能促进缺氧缺血性脑病的早期恢复,且疗效一致,两种剂量的促红细胞增生作用无差异,对其它系统均无不良影响。Objective ： To evaluate the neuroprotective effect and safety of the different dosage of recombinant human erythropoietin （rhEPO） on neonatal hypoxia-ischemia encephalopathy （HIE）. Methods： 76 cases HIE suited to the including criteria were randomized to either low dose EPO- treated group（29 cases） with the dosage of 300 U/kg/time, or high dose EPO-treated group （23 cases） with the dosage of 500 U/kg/time or control group（24 cases） without EPO treatment, rhEPO was injected subcutaneous for the first time and then instead of intravenous for each other day with 3 times each week for a duration of 2 weeks. The supportive care was same among the groups. Neurological scoring was evaluated at postnatal day（PND） 3, 5 and 7. Neonatal behavioral neurological assessment （NBNA） was evaluated at postnatal day 7, 14 and 28. Blood pressure, liver and renal function, blood electrolytes and blood hemoglobin, platelet and reticular red blood cell count were monitored before and after treatment in all the infants. Results： ①The scoring of NBNA showed a significant difference between EPO treated groups and control group. There was no significant difference between two EPO groups. ②The significant difference of the neurological scoring was achieved at seventh day of birth, which was significant lower in EPO treated group compared with control group. ③There were no difference in the liver and renal function, blood electrolytes, blood pressure and platelet count among three groups after treatment, except the hemoglobin and reticular red blood cell count increased in the rhEPO treated group. Conclusion： 300 U/kg or 500 U/kg dosage of rhEPO treatment on neonatal HIE infants could promote neurological recovery with the same effect. There was no serious side effect with rhEPO treatment.

关 键 词：促红细胞生成素 缺氧缺血性脑病 新生儿 

分 类 号：R722.1[医药卫生—儿科]