| 不同剂量重组人促红细胞生成素对早产儿脑损伤的作用研究 |
| 投稿时间：2017-04-19 修订日期：2017-05-30 点此下载全文 |
| 引用本文：赵娟,张丙宏.不同剂量重组人促红细胞生成素对早产儿脑损伤的作用研究[J].医学研究杂志,2018,47(2):107-111 |
| DOI：
10.11969/j.issn.1673-548X.2018.02.025 |
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| 中文摘要:目的 研究不同剂量重组人促红细胞生成素（rHu-EPO）治疗早产儿脑损伤的临床效果及不良反应。方法 收集2015年1月1日~2016年6月31入住笔者医院新生儿科的患儿，随机分为低剂量组、高剂量组及对照组，低、高剂量组分别给与rHu-EPO 500U/kg、1000U/kg皮下注射，每周3次，共3周。比较患儿治疗前、1周及3周后血清NSE及S100B浓度，定期完善头颅B超检查，比较生后1周及矫正胎龄40周时NBNA评分；比较治疗前后PLT、Hb、Urea、Cr、AST、ALT等，记录ROP、高血压及血管瘤例数，评估其不良反应。结果 低剂量组治疗1周时NSE、S100B与治疗前比较差异无统计学意义（P>0.05），3周后较治疗前降低（P<0.05）；高剂量组治疗1周、3周时均较治疗前降低（P<0.05）；各组矫正胎龄40周时NBNA评分均高于治疗前（P<0.05），低、高剂量组高于对照组（P<0.05）；低、高剂量组头颅B超出血吸收例数均多于对照组（P<0.05）；低、高剂量组输血例数少于对照组（P<0.05）；各组3周后Hb均低于治疗前（P<0.05），低、高剂量组高于对照组（P<0.05）；治疗前后PLT和肝肾功能比较差异无统计学意义（P>0.05）。结论 小剂量长期使用或者短期大剂量使用均能发挥治疗早产儿脑损伤的作用，尚未发现其不良反应。 |
| 中文关键词:重组人促红细胞生成素 早产儿 脑损伤 神经元特异性烯醇化酶 S100蛋白 新生儿神经行为测定 |
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| Effects of rHu-EPO in Different Dose on Brain Injury of Premature Infants |
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| Abstract:Objective To study the effects and side effects of different dose of rHu-EPO on the treatment of brain injury in premature infants.Methods The infants who had suffered fetal distress and first one minute of Apgar was under 7score after birth and were sent to NICU within 24h were studied.We totally collected 90 infants and divided into three groups randomly,including large dose group,small dose group and control group.The large and small group were injected hypodermicly with rHu-EPO 1000U/kg,500U/kg,three times per week for three weeks,and the control group were given general treatment without rHu-EPO at same time.Before treatment,one week and three weeks after treatment,we collected concentration of NSE,S100B and skull ultrasound to assess the effects.Neonatal behavioral neurological assessment(NBNA) were performed twice before and at weeks of correct gestational age.To survey the side effects,we collected general information such as the incidence rate of ROP and hemangioma,AST/ALT/PLT/Urea/Cr and so on.Results After one-week treatment,the concentration of NSE and S100B were no significant difference(P>0.05) in the small dose group,but were statistically significant in the large dose group(P<0.05).After three-week treatment,the comparison of NSE、S100B in both groups was statistically significant(P<0.05).The head ultrasound comparison was of statistically significant in both group(P<0.05),and so as NBNA and head MRI.The frequency of blood transfusion was statistically significant in both group(P<0.05) compared with control group.Routine blood test including liver and kidney function showed that there was no significant difference before and after treatment(P>0.05).Conclusion The neuroprotective effect of rHu-EPO on brain injury in preterm infants is connected with its dose and period of treatment,it need high dose or long time to express neuroprotective function. |
| keywords:Recombinant human erythropoietin Premature infant Brain injury NSE S100B NBNA |
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