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的疗效观察.docVIP

重组人促红细胞生成素防治极低出生体儿贫血及脑损伤的疗效观察 [摘要] 目的:探讨重组人促红细胞生成素（Recombinant Human Erythropoietin，rhu-EPO）防治极低出生体儿贫血及早产儿脑损伤的疗效及临床应用的安全性。将56例早产极低出生体儿随机分为对照组26例治疗组30例。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重组人促红细胞生成素（EPO），每周750 U/g，分3次皮下注射，共4周。观察组患儿的血红蛋白、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）和颅脑磁共振（MRI）检查。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下降的幅度小（P0.01），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（P0.01）；治疗组输血例数及多次输血例数均明显低于对照组（P0.05）；治疗组纠正胎龄40周时的NBNA评分较对照组高，P0.01）。治疗组纠正胎龄40周时脑电图（EEG）及颅脑磁共振（MRI）检查异常率较对照组低（P0.05）。结论：早期应用rhuEPO能提高极低出生体儿血红蛋白、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。 促红细胞生成素；早产儿；极低出生体；贫血；脑损伤 Observation of Recombinant Human Erythropoietin on very-low-birth-weight Infants of Anemia and Brain Damage Li Yingying, Huang Qiling, Zhu Feng, Liu Xianglei（Suzhou Hospital of Anhui Medical University, Anhui Suzhou 234000,China） [Abstract] Objective: To investigate the efficacy of recombinant human erythropoietin(rhuEPO) on preventing very-low-birth-weight infants and premature infants from anemia and brain damage..Methods： 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 vitaminE at the 8th postnatal day.The treatment group（30 cases）were given rhuEPO on the basis treatment of those in control group,750U/Kg for a 3-dose,4 weeks.The hemoglobin ,hematocrit, reticulocyte count ,blood transfusion rates and transfusion frequency 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（P0.01）.The reticulocyte in control group increased.There was a singnificant difference compared with that of control group（P0.01）.The blood transfusion rates and transfusion fre