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目的 探讨重组人类促红细胞生成素 (rhEpo)治疗早产儿贫血的疗效及最适剂量。 方法 予rhEpo75 0IU/ (kg·w) (Ⅰ组 )、6 0 0IU/ (kg·w) (Ⅱ组 )、45 0IU/ (kg·w) (Ⅲ组 )、30 0IU/ (kg·w) (Ⅳ组 ) ,分别治疗 15例胎龄 35周以下、出生体重 <180 0 g的早产儿 ,并与 15例同胎龄、同出生体重的早产儿 (Ⅴ组 )对照。 结果 ① 5组早产儿生后血红蛋白 (Hb)、红细胞压积比 (ΦRBC)均逐步下降 ,但Ⅰ组下降程度最轻 ,对照组下降程度最明显。治疗结束时 ,经方差分析 ,除了Ⅲ组与Ⅳ组之间无显著性差异外 ,其余各剂量组之间差异有显著性意义。②Ⅰ～Ⅳ组第 2周起网织红细胞 (Ret)较对照组升高 (P均 <0 0 1) ,并且与剂量有关 ;治疗结束时 ,各剂量组差异已不显著 ,但仍高于对照组 (P <0 0 1)。③Ⅰ～Ⅳ组第 2周血清铁明显低于对照组 ,第 4周更甚 ;治疗结束时 ,治疗组血清铁上升 ,但Ⅰ～Ⅲ组仍低于对照组 (P <0 0 1)。结论 rhEpo可提高Hb、ΦRBC及Ret,并且疗效与剂量有关 ,75 0IU/ (kg·w)组疗效最显著
Objective To investigate the efficacy and optimal dose of recombinant human erythropoietin (rhEpo) in the treatment of anemia in premature infants. Methods One hundred and sixty IU / (kg · w) of rhEpo75 (group Ⅰ), 60IU / (kg · w) (group Ⅱ) and 45IU / (kg · w) (Group Ⅳ). 15 preterm infants with gestational age less than 35 weeks and birth weight <180 g were treated with 15 pregnant women with gestational age and same birth weight (group V). Results ① The hemoglobin (Hb) and the erythrocyte sedimentation rate (ΦRBC) of premature infants in 5 groups were gradually decreased, but the decrease was the lightest in group Ⅰ and the most obvious in control group. At the end of treatment, the variance analysis showed that there were significant differences among the other dose groups except that there was no significant difference between group Ⅲ and group Ⅳ. ② The reticulocyte (Ret) in I ~ IV group was higher than that in control group at the second week (P <0.01), and was dose-dependent. At the end of treatment, there was no significant difference between each dose group and the control group Group (P <0 0 1). Serum iron in the second and third weeks of Ⅰ ~ Ⅳ group was significantly lower than that of the control group at the fourth week. Serum iron increased in the treatment group at the end of the treatment period, but the levels in the Ⅰ ~ Ⅲ group were still lower than those in the control group (P <0.01). Conclusion rhEpo can increase Hb, ΦRBC and Ret, and the effect is dose-dependent. The effect of 75IU / (kg · w) is the most significant