国产重组人类促红细胞生成素预防早产儿贫血  

The Preventive Effects of Recombinant Human Erythropoietin on the Anemia of Premature Birth Infant

作　　者：涂绘玲[1] 叶鸿瑁[1] 朴梅花[1] 王丹华[2] 李春涛 张巍[4] 黄德珉[1] 罗凤珍[1] 

机构地区：[1]北京大学第三医院儿科,100083 [2]中国医学科学院北京协和医科大学北京协和医院 [3]海淀区妇幼保健院 [4]首都医科大学附属北京市妇产医院

出　　处：《中华围产医学杂志》2003年第2期88-92,共5页Chinese Journal of Perinatal Medicine

摘　　要：目的　观察重组人类促红细胞生成素 (r Hu EPO,商品名宁红欣 )对早产儿贫血的预防作用。　方法　将来自四所医院的 5 1例胎龄小于 35周、体重小于 2 0 0 0 g的早产儿随机分为预防组(31例 )和对照组 (2 0例 )。预防组予 r Hu EPO2 5 0 IU/ (kg·次 ) ,静脉或皮下注射 ,隔日 1次 ,每周 3次 ,共 4周。观察两组早产儿血红蛋白 (Hb)、红细胞压积 (Hct)、网织红细胞 (Ret)、血清铁及促红细胞生成素 (EPO)的动态变化。　结果　两组早产儿生后 Hb、Hct均逐渐下降 ,但预防组下降明显小于对照组 ,经 t检验 ,两组之间差异有显著性 (P<0 .0 0 1)。对照组有 4例输血 ,而预防组无一例输血 ,经精确 χ2检验 ,差异有显著性 (P=0 .0 19)。预防组 1周末 Ret较对照组明显升高 ,差异有显著性 (P<0 .0 5 )。预防组 2周末血清铁低于对照组 ,4周末更甚 ,经比较差异有非常显著性 (P<0 .0 1)。预防组EPO水平较对照组明显上升 ,差异有非常显著性 (P<0 .0 1)。　结论　早产儿预防性应用 r Hu EPO可减轻 Hb、Hct、Ret的下降程度 ,不需要输血和输血次数减少 ,r Hu EPO预防早产儿贫血有一定效果。Objective To assess the preventive effects of recombinant human erythropoietin (rHu EPO) on the anemia of premature birth infant. To determine whether prophylactic treatment with rHu EPO and iron would reduce the postnatal hemoglobin (Hb) decline and blood transfusion of premature infants. Methods Fifty one infants of less than 35 weeks of gestation and 2000 g of birth weight from multicenter were randomly assigned to EPO group ( n =31) and control group ( n =20). Infants in EPO group received rHuEPO 250 IU/(kg·t) intravenously or subcutaneously once every second day, started between 2 and 10 days of age, maintained for 4 weeks. Oral iron and vitamin E supplements were given to all infants. Hb, hematocrit (Hct), reticulocyte counts (Ret), serum iron and erythropoietin (EPO) were detected in both groups. Results Postnatal decline of Hb and Hct were less in EPO group than that in the control group at the end of study (129.9±21.0 vs 103.2±14.3, P <0.001; 37±8 vs 29±5, P <0.001, respectively). The need for blood transfusion was also reduced in EPO group: none vs 20% (4 cases) of infants received transfusion( P < 0.001). Infants in EPO group had significantly higher Ret 0.024 vs 0.006, P <0.001 at the end of first week of treatment. After treatment, serum iron reduced more significantly in the EPO group than that in control group( P < 0.01 ). Whereas, serum EPO level was significant higher in the EPO group( P < 0.01 ). No side effects related to rHuEPO therapy were observed. Conclusions rHuEPO is effective in some degree in the prevention of anemia of premature birth infant, it enhances erythropoiesis and reduces the need for blood transfusion; in addition, it is safe in premature infants.

关 键 词：促红细胞生成素 预防 早产儿 贫血 

分 类 号：R722.6[医药卫生—儿科]