重组人促红细胞生成素防治极低出生体质量儿贫血及脑损伤疗效观察  

Efficacy Observation of Recombinant Human Erythropoietin on Very-Low-Birth-Weight Infants of Anemia and Brain Damage

作　　者：李莹莹[1] 黄启凌[1] 朱峰[1] 刘祥蕾 

机构地区：[1]安徽医科大学附属宿州医院,安徽宿州234000

出　　处：《儿科药学杂志》2015年第1期17-20,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨重组人促红细胞生成素(rhu-EPO)防治极低出生体质量儿贫血及早产儿脑损伤的疗效及安全性。方法:将56例早产极低出生体质量儿随机分为对照组26例和治疗组30例。两组患儿均在生后第8天开始给予复方硫酸亚铁叶酸片和维生素E,而治疗组患儿在此基础上使用rhu-EPO,每周750 U/kg,分3次皮下注射,共4周。观察两组患儿的血红蛋白、红细胞压积、网织红细胞计数、输血率、输血次数,于纠正胎龄40周时对所有患儿进行新生儿行为神经测定(NBNA),并行脑电图(EEG)和颅脑磁核共振(MRI)检查。结果:两组患儿血红蛋白和红细胞压积均下降,治疗组下降幅度较对照组小(P<0.01),治疗组网织红细胞计数在治疗后明显上升,与对照组比较差异有统计学意义(P<0.01);治疗组输血例数及多次输血例数均明显少于对照组(P<0.05);治疗组纠正胎龄40周时的NBNA评分较对照组高,两组比较差异有统计学意义(P<0.01)。治疗组纠正胎龄40周时EEG及MRI检查异常率较对照组低(P<0.05)。结论:早期应用rhu-EPO能提高极低出生体质量儿血红蛋白、红细胞压积、网织红细胞计数,防治早产儿贫血,同时能改善早产儿脑损伤的预后。Objective： To investigate the efficacy of recombinant human erythropoiefin （rhu-EPO） on preventing very-low-birth-weight infants and premature infants from anemia and brain damage. Methods： Fifty-six premature very-low-birth-weight infants were randomized into the treatment group and the control group. The control group （26 cases） were given compound ferrous sulfate capsule and vitamin E at the 8th postnatal day. The treatment group （30 cases） was given rhu-EPO on the basis treatment of those in control group, 750 U/kg for a 3-dose, 4 weeks. The hemoglobin, hematocrit, reticulocyte count, blood transfusion rates and transfusionfrequency were observed. The neonatal behavioral neurological assessment （NBNA）, electroencephalography （EEG）, and cranial MRI were carried when they were corrected gestational age of 40 weeks. Results ： The hemoglobin and hematocrit of two groups both gradually declined, whereas, descend range in the treatment group significantly less than those of the control group （P〈0.01）. The reticulocyte in control group increased, there was a significant difference compared with that of control group （P〈0.01）. The blood transfusion rates and transfusion frequency in treatment group were significantly lower than that of control group （P〈0.05）. Treatment group corrected gestational age of 40 weeks NBNA score was higher than that in the control group, two groups of contrast were statistically different （P〈0.01）. Treatment group corrected gestational age of 40 weeks EEG and cranial MRI abnormality rates were lower than those in control group （P〈0.05）. Conclusion： Early application of rhu-EPO could increase Hb, Hct, and Ret, and prevent the anemia of prematurity and could improve the prognosis.

关 键 词：促红细胞生成素 早产儿 极低出生体质量儿 贫血 脑损伤 

分 类 号：R722.1[医药卫生—儿科]