重组人促红细胞生成素对HIE早产儿炎性因子、血气分析指标及神经功能的影响  

Effects of rhEPO on inflammatory factors,blood gas analysis indexes and nerve function of premature infants with hypoxic-ischemic encephalopathy

作　　者：周良芬[1] 谭若锟[1] 谭宁[1] Zhou Liangfen;Tan Ruokun;Tan Ning(Department of Neonatology,the Chenzhou N0.1 Peopled Hospital,Hunan 423000,China)

机构地区：[1]郴州市第一人民医院新生儿科,湖南423000

出　　处：《脑与神经疾病杂志》2021年第9期568-571,共4页Journal of Brain and Nervous Diseases

基　　金：湖南学院2019年度校级科研项目(2019XJ68);吴阶平医学基金会临床科研专项资助(320675019094-25)。

摘　　要：目的探讨重组人促红细胞生成素(rhEPO)对低氧缺血性脑病(HIE)早产儿炎性因子、血气分析指标及神经功能的影响。方法本研究纳入2018年5月至2020年5月湖南省郴州市第一人民医院新生儿科收治的116例HIE早产儿作为研究对象,将患儿按照随机数字表法分为观察组(n=58)和对照组(n=58),对照组患儿给予常规治疗,观察组患儿于出生后次日在常规治疗基础上给予rhEPO治疗,两组患儿均连续治疗2w,比较两组患儿治疗前后白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、细胞间黏附分子-1(ICAM-1)、氧分压(Pa02)、二氧化碳分压(PaC02)、pH值及血氧饱和度(SaO_(2))差异性,并比较治疗后3个月、6个月新生儿神经行为测定评分(NBNA)、神经发育指数(MDI)和心理运动发育指数(PDI)差异性。结果治疗后两组患儿血清炎性因子IL-1β、TNF-α、ICAM-1水平较治疗前均显著降低(P<0.05),且观察组患儿血清炎性因子IL-1β、TNF-α、ICAM-1水平较对照组降低更为显著(P<0.05)。治疗后两组患儿的血气分析指标PaO_(2)、PaCO_(2)、pH值、SaO_(2)较治疗前均明显改善(P<0.05),且观察组患儿血气分析指标PaO_(2)、PaCO_(2)、pH值、SaO_(2)较对照组改善更为明显(P<0.05)。观察组患儿治疗后3个月、6个月的NBNA、MDI、PDI评分均显著高于对照组,差异有统计学意义(P<0.05)。结论rhEPO可有效降低HIE早产儿炎性因子水平,改善患儿血气分析指标,促进患儿神经行为发育。Objective To investigate the effect of recombinant human erythropoietin(rhEPO)on inflammatory factors,blood gas analysis indexes and nerve function of premature infants with hypoxic-ischemic encephalopathy(HIE).Methods 116 cases of premature infants with HIE admitted to our hospital from May 2018 to May 2020 were included in this study.The children were randomly divided into observation group(n=58)and control group(n=58).The control group was given conventional treatment,while the observation group was given rhEPO on the basis of routine treatment the next day after birth.Both groups were treated for 2 weeks.The inflammatory factors(interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),intercellular adhesion molecule-1(ICAM-1))and blood gas analysis indexes(partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),pH value(pH),blood oxygen saturation(SaO_(2))were compared between the two groups before and after treatment.The differences of NBNA,MDI and PDI were compared at 3 and 6 months after treatment.Results After treatment,the serum levels of IL-1β,TNF-α,ICAM-1 in the two groups were significantly lower than those before treatment(P<0.05),and the levels of IL-1β,TNF-α,ICAM-1 in the observation group were significantly lower than those in the control group(P<0.05).After treatment,PaO_(2),PaCO_(2),pH and SaO_(2)of the two groups were significantly improved compared with those before treatment(P<0.05),and PaO_(2),PaCO_(2),pH and SaO_(2)of the observation group were improved more significantly than those of the control group(P<0.05).The NBNA,MDI and PDI scores of the observation group were significantly higher than those of the control group at 3 and 6 months after treatment,and the difference was statistically significant(P<0.05).Conclusion rhEPO can effectively reduce the level of inflammatory factors in preterm infants with HIE,improve blood gas analysis indexes and promote neurobehavioral development of children.

关 键 词：低氧缺血性脑病 早产儿 重组人促红细胞生成素 炎性因子 血气分析 神经功能 

分 类 号：R747.9[医药卫生—神经病学与精神病学]