促红细胞生成素联合亚低温治疗中重度新生儿缺氧缺血性脑病疗效及治疗期间安全性分析  

Efficacy and safety analysis of EPO combined with mild hypothermia in the treatment of moderate to severe HIE

作　　者：李修晶[1] 赵芳萍[1] 刘东海[1] 石静云[1] 谈笑[1] 王陆军[1] LI Xiujing;ZHAO Fangping;LIU Donghai;SHI Jingyun;TAN Xiao;WANG Lujun(Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃省妇幼保健院,兰州730000

出　　处：《实用医学杂志》2021年第1期57-62,共6页The Journal of Practical Medicine

基　　金：甘肃省卫生行业科研计划项目(编号:GSWSKY2017⁃42)。

摘　　要：目的探讨促红细胞生成素(erythropoietin,EPO)联合亚低温治疗中重度新生儿缺氧缺血性脑病(hypoxic⁃ischemic encephalopathy,HIE)的疗效及安全性。方法选取我院2017年3月至2019年7月收治的满足亚低温标准的中重度HIE患儿92例进行随机对照研究,根据随机数字表法分组,各46例,实验组采用亚低温治疗72 h联合EPO静滴(隔天1次,治疗14 d),对照组给予亚低温治疗72 h及与EPO同等剂量、同样给药方法的生理盐水。统计对比两组治疗期间安全性、常规生化指标,并对比两组疗效、新生儿行为量表(NBNA)、智能发育(CDCC)评分、后遗症发生率等预后情况。结果(1)疗效及预后:实验组出生后7、14、28 d NBNA评分呈升高趋势,且均大于对照组(P<0.05);实验组3月龄、6月龄、12月龄的MDI、PDI评分均大于对照组(P<0.05);实验组后遗症发生率(8.70%)与对照组(13.04%)比较,差异无统计学意义(P>0.05);(2)常规生化指标:EPO治疗结束后观察组Hb、RBC、HcT高于对照组,PLT低于对照组,差异有统计学意义(P<0.05);(3)治疗期间安全性:两组治疗期间均无严重不良事件、放弃治疗事件、死亡事件发生,两组一般不良事件发生率对比,差异无统计学意义(P>0.05)。结论EPO联合亚低温治疗HIE能进一步减轻患儿智力、神经损伤,提高预后,且不增加治疗期间不良事件发生风险。Objective To investigate the efficacy and safety of erythropoietin(EPO)combined with mild hypothermia in the treatment of moderate to severe neonatal hypoxic⁃ischemic encephalopathy(HIE).Methods A randomized controlled study was conducted on 92 children with moderate to severe HIE who met the mild hypothermia criteria from March 2017 to June 2019 in our hospital,and they were grouped according to the random number table method,46 cases each.The experimental group was treated with mild hypothermia for 72 hours combined with EPO intravenous infusion(once every other day for 14 days),and the control group was given mild hypother⁃mia for 72 hours and normal saline at the same dose and same method as EPO.Statistics compared the safety and routine biochemical indicators of the two groups during treatment,and compared the prognosis of the two groups,such as the efficacy,newborn behavior scale(NBNA),intelligent development(CDCC)score,and the incidence of sequelae.Results(1)the NBNA scores of 7 days,14 days,and 28 days after birth in the experimental group showed an increasing trend,and were all greater than those in the control group(P<0.05);the MDI and PDI scores of the 3⁃month⁃old,6⁃month⁃old and 12⁃month⁃old in the experimental group were larger than those in the control group(P<0.05);the incidence of sequelae in the experimental group was 8.70%compared with 13.04%in the control group,the difference was not statistically significant(P>0.05);(2)Conventional biochemical indicators:at the end of mild hypothermia treatment,after the end of EPO treatment,the two groups of Hb,RBC,HcT,PLT,alanine aminotransferase,myocardial enzymes,creatinine,CR were compared,the difference was not statistically significant(P>0.05);(3)Safety during treatment:there were no serious adverse events,treatment abandonment events,and death events during treatment between the two groups.There was no statistically signifi⁃cant difference in the incidence of general adverse events between the two groups(P>0.05).Conclusion EPO combine

关 键 词：促红细胞生成素 亚低温 新生儿缺氧缺血性脑病 不良事件 智能发育 

分 类 号：R722.1[医药卫生—儿科]