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目的观察促红细胞生成素(EPO)治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法 81例HIE患儿随机分为治疗组(42例)和对照组(39例)。同时选取同一时期健康足月儿43例作为正常组。对照组及治疗组患儿均给予常规治疗;EPO治疗组在常规治疗的基础上,给予静脉注射EPO每日200 IU/kg,每周3次,每6天查血常规1次,根据血常规结果调整EPO剂量,疗程为2周。所有患儿于生后的7、14、28 d进行新生儿行为测定(NBNA),生后的3个月和6个月进行婴幼儿智能发育评估(CDCC)。并于生后6个月和12个月进行随访。结果生后7 d的NBNA评分治疗组与对照组无统计学差异,均低于正常组(P<0.01);14、28 d时治疗组NBNA评分均高于对照组(P<0.05),但仍低于正常组(P<0.01);3月龄CDCC评分(包括MDI、PDI评分)治疗组正常者比例高于对照组(P<0.05),但低于正常组(P<0.01)。6月龄CDCC评分治疗组正常者比例高于对照组(P<0.05),治疗组M DI评分正常者比例与正常组相比较,差异无统计学意义,但PDI评分正常者比例仍低正常组(P<0.05)。结论应用EP0治疗新生儿HIE疗效较好,优于对照组治疗。
Objective To observe the efficacy of erythropoietin (EPO) in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE). Methods 81 cases of HIE were randomly divided into treatment group (42 cases) and control group (39 cases). At the same time, 43 healthy full-term children were selected as the normal group in the same period. The control group and the treatment group were given routine treatment; EPO treatment group on the basis of routine treatment, given intravenous EPO daily 200 IU / kg, 3 times a week, every 6 days routine examination of blood, according to blood routine EPO dose adjustment results, treatment period of 2 weeks. All children underwent Neonatal Behavioral Assay (NBNA) at 7,14,28 d after birth, and the Intelligent Developmental Evaluation of Infants and Toddlers (CDCC) at 3 and 6 months after birth. And 6 months and 12 months after birth were followed up. Results NBNA score at 7 days after birth was not significantly different from that of the control group (P <0.01). The NBNA score of the treatment group at 14 and 28 days was significantly higher than that of the control group (P <0.05) (P <0.01). The 3-month-old CDCC scores (including MDI and PDI scores) in the treatment group were higher than those in the control group (P <0.05), but lower than those in the normal group (P <0.01). The proportion of patients with normal CDC score at 6 months was higher in the treatment group than in the control group (P <0.05). The proportion of patients with normal M DI score in the treatment group was not significantly different from that in the normal group, but the proportion of patients with normal PDI score was still lower than that in the normal group (P <0.05). Conclusion EPO treatment of neonatal HIE better effect, better than the control group.