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目的:初步探讨亚低温与促红细胞生成素(Erythropoietin,EPO)的联合应用对新生儿窒息及缺氧缺血性脑损伤的安全性。方法:将符合入选标准的窒息新生儿随机分为联合组(16例)、低温组(24例)及常规组(25例),并对各组治疗前(治疗0h)及治疗后(治疗72～96h)的血凝分析、血小板、肝肾功能等指标及临床情况进行对照分析。结果:①治疗前3组患儿的凝血酶原时间(PT)、凝血酶时间(TT)均轻度延长,治疗后均有好转,3组患儿治疗前、后血小板计数均属正常范围。②治疗前3组患儿的BUN、Cr、ALT及AST均有不同程度的升高,治疗后均有下降,联合组的各项指标与低温组、常规组及治疗前相比差异无统计学意义。③联合组临床无严重感染、重度硬肿症等严重并发症发生。结论:全身亚低温与EPO的联合应用对窒息儿的血凝及肝肾功能等无明显不良影响,也不会加重其器官功能损害。
Objective: To investigate the safety of combined use of mild hypothermia and erythropoietin (EPO) on neonatal asphyxia and hypoxic-ischemic brain damage. Methods: Newborns with asphyxia who meet the inclusion criteria were randomly divided into the combined group (n = 16), the hypothermia group (n = 24) and the conventional group (n = 25) ~ 96h) hemagglutination analysis, platelets, liver and kidney function and other indicators and clinical data were analyzed. Results: ① Prothrombin time (PT) and thrombin time (TT) were slightly prolonged in all three groups before treatment, and were improved after treatment. The platelet counts of the three groups before and after treatment were in the normal range. ②The levels of BUN, Cr, ALT and AST in the three groups before treatment were all increased to some extent after treatment, and all the indexes in the combined group had no statistical difference with those in the low-temperature group, the conventional group and before treatment significance. ③ joint group clinically no serious infection, severe sclerosis and other serious complications. Conclusion: The combined application of whole body hypothermia and EPO has no obvious adverse effect on the hemagglutination, liver and kidney function of asphyxia children and does not aggravate the organ dysfunction.