促红细胞生成素防治早产儿贫血临床观察.docVIP

促红细胞生成素防治早产儿贫血临床观察[摘要] 目的：观察重组人促红细胞生成素（rhEPO）防治早产儿贫血的临床效果。方法：将96例早产儿（胎龄30～35周）随机分为观察组和对照组各48例。对照组给予常规治疗；观察组除常规治疗外，从出生第7天开始给予rhEPO 250 IU/（kg1次，每周3次，皮下注射，共用药4周，必要时输血。分别检测用药前、用药后4周血常规红细胞（RBC）、血红蛋白（Hb）、红细胞压积（HCT）、网织红细胞（Ret）等指标的变化。结果：两组血常规各项指标进行对比分析，观察组与对照组比较，差异有统计学意义（P＜0.05）。观察组输血发生率显著低于对照组（P＜0.05）（观察组为16.7%，对照组为39.6%）。结论：促红细胞生成素防治早产儿贫血效果明显，可减少输血次数。 [关键词] 促红细胞生成素；早产儿；贫血；临床观察 [中图分类号] R722 [文献标识码]A[文章编号]1674-4721（2011）06（a）-028-02 Erythropoietin in anemia prevention and control clinical observation of premature children HOU Shuping Department of Pediatrics, Puyang City Oil Field General Hospital, Henan Province, Puyang 457001, China [Abstract] Objective: To observe the recombinant human erythropoietin (rhEPO) control the clinical effects of anemia in premature children. Methods: 96 preterm children (gestational age 30 to 35 weeks) were randomly divided into two groups and the control group of 48 cases. The control group received conventional therapy; observation group in addition to conventional treatment, the 7th day from birth to give rhEPO 250 IU/(kg?time), every other day for 1, 3 times a week, administered subcutaneously 4 weeks, if necessary, blood transfusions. Detected before treatment, 4 weeks after treatment blood red blood cell (RBC), hemoglobin (Hb), hematocrit (HCT), reticulocytes (Ret) and other indicators of change. Results: Both groups were analyzed blood indicators was observed compared with the control group, the difference was statistically significant (P 研究表明[2]，红细胞生成是由EPO的反馈机制调节，即红细胞数目减少时EPO升高，后者促进红细胞生成而使红细胞数量上升。而红细胞数量增多时又反馈性抑制EPO的产生。儿童或成人在轻度组织缺氧时有内源性EPO产生增加。早产儿生成EPO的部位在肝脏，出生数周后才过渡到肾脏，胎龄越小其肝脏所产生的EPO比例越大，而肝脏对于缺氧的敏感性比肾脏弱，早产儿骨髓对EPO的反应亦相对迟钝，且早产儿Hb下降与EPO上升的相关性很差，使EPO产生明显不足。 传统方法治疗早产儿贫血常采用输血治疗，但输血常并发溶血、感染、过敏、传染疾病尤其是乙肝、艾滋病等。rhEPO是含有与天然分离的EPO完全相同氨基酸序列的糖蛋白，且与天然EPO具有相同的生物学活性。研究认为[3-5]，rhEPO能刺激早产儿骨髓及循环中红细胞系的前体细胞正常的增殖和分化，增加早产儿生后Ret的值，减轻早产儿生后Hb、HCT的下降，降低早产儿贫血的发生率。文献报道[6]，贫血的早产儿早期应用rhEPO治疗可增进红细胞的产生、减少输血次数和输血量，甚至可达到无需输血的效果。本文观察结果显示，两