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目的 评价不同剂量的重组人类红细胞生成素 (rHuEPO)预防早产儿贫血的效果。方法 选择2 0 0 0～ 2 0 0 2年广州医学院荔湾医院收治的 6 7例胎龄≤ 34周 ,出生体重≤ 2 0kg早产儿 ,随机分为大剂量组、小剂量组和对照组。大、小剂量组分别于生后 3～ 7d接受rHuEPO每周 5 0 0IU/kg和每周 15 0IU/kg ,每周分 2次 ,皮下注射 ,共 6周 ;3组治疗期间均予 3～ 8mg·kg-1·d-1元素铁口服。分别于生后 1～ 8周、12周、16周观察各项血液学指标。结果 完成 16周研究的早产儿共 5 8例 ,3组生后血红蛋白、红细胞压积比均逐渐下降 ,大剂量组下降幅度最小 ,对照组下降最明显 (均P <0 0 1) ;大、小剂量组较对照组血红蛋白和红细胞压积比达最低值的时间提前。大、小剂量组网织红细胞于rHuEPO治疗 1周后即较对照组明显升高 ,尤以大剂量组上升幅度最明显 (P <0 0 1) ,治疗第 2～ 3周达高峰。 3组血清铁生后均呈下降趋势 ,但治疗期间治疗组下降较对照组明显 (P <0 0 1)。结论 rHuEPO辅以铁剂治疗可有效地预防早产儿贫血 ,且rHuEPO每周 5 0 0IU/kg优于每周 15 0IU/kg。
Objective To evaluate the effect of different doses of recombinant human erythropoietin (rHuEPO) in preventing anemia in preterm infants. Methods Sixty-seven preterm infants born at Liwan Hospital, Guangzhou Medical College from 2000 to 2002 with gestational age ≤ 34 weeks and birth weight ≤ 20 kg were randomly divided into high-dose group, low-dose group and control group. Large and small dose groups were received rHuEPO weekly 500 IU / kg and weekly 150 IU / kg 3 to 7 days after birth, 2 times a week, subcutaneous injection for 6 weeks; 3 groups were treated during 3 ~ 8mg · kg-1 · d-1 element iron oral administration. The hematological indexes were observed at 1 ~ 8 weeks, 12 weeks and 16 weeks after birth. Results A total of 58 preterm infants completed the 16-week study. The hemoglobin and hematocrit ratios of the three groups decreased gradually after the 16-week study. The decrease rate of the high-dose group and the control group were the most significant (all P <0.01) Small-dose group than the control group hemoglobin and hematocrit than the lowest value of the time ahead. Large and small doses of reticulocytes in rHuEPO treatment after 1 week was significantly higher than the control group, especially in the high-dose group the most significant increase (P <0.01), the treatment of the first 2 to 3 weeks peaked. The serum iron levels of the three groups showed a decreasing trend, but the treatment group decreased significantly compared with the control group (P <0.01). Conclusions rHuEPO supplemented with iron can effectively prevent anemia in preterm infants, and rHuEPO is better than 150 IU / kg per week.