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目的探讨早期大剂量重组人促红细胞生成素(rhu-EPO)对早产儿神经发育的保护作用。方法选取符合条件的早产儿共42例,随机分为2组,治疗组和对照组各21例。两组患儿生后院内均予常规治疗及出院后早期干预治疗。治疗组于生后1、2、3天分别经静脉给予EPO1000U/kg。比较两组早产儿①生后3天内头颅B超及以后每周至少一次至出院时头颅B超异常发生率;纠正胎龄40周时、3个月、6个月头颅CT或MRI异常率;②在纠正胎龄40周时的新生儿神经行为测定(NBNA);纠正胎龄6个月、12个月Gesell发育量表评分;③纠正胎龄40周、6个月、12个月脑干听觉诱发电位(ABR)异常率。结果①EPO治疗组头颅B超、头颅CT或MR异常率低于对照组,两组间有显著性差异;②NBNA及Gesell发育量表评分治疗组优于对照组,差异有显著性;③ABR于纠正胎龄40周时两组间无显著差异,纠正胎龄6、12个月时治疗组异常率均较对照组低,且有显著性差异。结论早期大剂量使用EPO可显著改善早产极低出生体重儿儿预后,促进其神经系统发育。
Objective To investigate the protective effects of early high-dose recombinant human erythropoietin (rhu-EPO) on neurodevelopment in premature infants. Methods Forty-two eligible preterm infants were randomly divided into two groups, 21 in each of the treatment group and the control group. The two groups of children were born after the hospital routine treatment and discharge early intervention. The treatment group were administered with EPO1000U / kg intravenously after 1, 2 and 3 days. The incidences of B-ultrasound in the two groups were compared between the first three days after birth and at least one week after the discharge to the hospital. The abnormalities of cranial CT or MRI were corrected at 40 weeks, three months and six months. ② Neonatal behavioral testing (NBNA) corrected for gestational age at 40 weeks; Correct gestational age 6 months, 12 months Gesell scale score; ③ corrected gestational age 40 weeks, 6 months, 12 months brain stem Auditory evoked potential (ABR) abnormal rate. Results ① The abnormalities of B-ultrasound, cranial CT or MR in EPO-treated group were lower than those in control group, with significant difference between the two groups. ② The scores of NBNA and Gesell’s developmental scale were better in treatment group than in control group, At 40 weeks of age, there was no significant difference between the two groups. When the gestational age was corrected at 6 and 12 months, the abnormal rate in the treatment group was lower than that in the control group, and there was a significant difference. Conclusion Early high-dose EPO can significantly improve the prognosis of preterm low birth weight infants and promote their nervous system development.