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目的:探讨重组人促红细胞生成素(rhu-EPO)防治极低出生体质量儿贫血及早产儿脑损伤的疗效及安全性。方法:将56例早产极低出生体质量儿随机分为对照组26例和治疗组30例。两组患儿均在生后第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rhu-EPO,每周750 U/kg,分3次皮下注射,共4周。观察两组患儿的血红蛋白、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)和颅脑磁核共振(MRI)检查。结果: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小(P<0.01),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(P<0.01);治疗组输血例数及多次输血例数均明显少于对照组(P<0.05);治疗组纠正胎龄40周时的NBNA评分较对照组高,两组比较差异有统计学意义(P<0.01)。治疗组纠正胎龄40周时EEG及MRI检查异常率较对照组低(P<0.05)。结论:早期应用rhu-EPO能提高极低出生体质量儿血红蛋白、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。
Objective: To investigate the efficacy and safety of recombinant human erythropoietin (rhu-EPO) in the prevention and treatment of very-low birth-weight anemia and brain injury in premature infants. Methods: 56 cases of preterm low birth weight children were randomly divided into control group of 26 cases and treatment group of 30 cases. The two groups of children were given compound ferrous sulfate folic acid tablets and vitamin E on the 8th day after birth. The children in the treatment group were given rhu-EPO at a dose of 750 U / kg weekly for 3 times, A total of 4 weeks. The hemoglobin, hematocrit, reticulocyte count, blood transfusion rate and number of blood transfusion in both groups were observed. Neonatal Behavioral Nerve Measurement (NBNA) and EEG ) And cranial magnetic resonance imaging (MRI). Results: The hemoglobin and hematocrit decreased in both groups, and the decreasing rate in the treatment group was smaller than that in the control group (P <0.01). The reticulocyte count in the treatment group increased significantly after treatment, which was significantly different from that in the control group P <0.01). The number of transfusions and the number of transfusions in the treatment group were significantly less than those in the control group (P <0.05). The NBNA score of the treatment group at the 40th week of gestational age was higher than that of the control group Significance (P <0.01). The abnormal rate of EEG and MRI examination in the treatment group corrected for gestational age at 40 weeks was lower than that in the control group (P <0.05). Conclusion: Early application of rhu-EPO can improve the hemoglobin, hematocrit and reticulocyte count of very low birth weight children, prevent and cure anemia in premature infants and improve the prognosis of brain injury in premature infants.