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目的探讨不同剂量的重组人促红细胞生成素(rh EPO)在极低出生体重儿(VLBWI)脑损伤治疗中的临床效果及安全性。方法选取2014年10月~2016年10月在本院儿科收治的确诊为脑损伤的VLBWI 118例,随机分为大剂量组45例、小剂量组43例、对照组30例。大剂量组及小剂量组在出生后7 d内分别给予rh EPO 1 000 U·kg~(-1)、500 U·kg~(-1)静脉注射,连用3 d,对照组只给予常规对症治疗。观察各组治疗效果及安全性。结果大剂量组血清中EPO、S100B、IL-6水平分别与小剂量组、对照组比较,差异有统计学意义(P<0.05);小剂量组各项指标和对照组比较,差异无统计学意义(P>0.05);大剂量组NBNA评分、6个月及12个月PDI、MDI评分分别与对照组比较,差异有统计学意义,P<0.05;各组12个月PDI、MDI评分与6个月时指标比较,差异均有统计学意义(P<0.05);大剂量组和其他两组比较,12个月时PDI、MDI改善更明显(P<0.05)。结论大剂量rh EPO在VLBWI脑损伤治疗中效果优于小剂量,且较安全,临床可以推广应用。
Objective To investigate the clinical effects and safety of different doses of recombinant human erythropoietin (rh EPO) in the treatment of VLBWI brain injury. Methods A total of 118 VLBWI patients diagnosed as brain injury in our hospital from October 2014 to October 2016 were randomly divided into high dose group (n = 45), low dose group (n = 43) and control group (n = 30). The high-dose group and the low-dose group were given rh EPO at 1 000 U · kg -1 and 500 U · kg -1 intravenously on the 7th day after birth for 3 days respectively. The control group was given only conventional symptomatic treatment treatment. Observed the treatment effect and safety of each group. Results The levels of EPO, S100B and IL-6 in the high-dose group were significantly lower than those in the low-dose group and the control group (P <0.05). There was no significant difference between the low-dose group and the control group (P> 0.05). The NBNA score, 6-month and 12-month PDI and MDI scores in high dose group were significantly lower than those in control group (P <0.05). The scores of PDI, Compared with other two groups, the indexes of PDI and MDI improved significantly at 12 months in high-dose group (P <0.05). Conclusion High dose rh EPO is superior to low dose in the treatment of VLBWI brain injury, and it is safe and can be widely applied in clinic.