摘要
目的研究重组人促红细胞生成素(r Hu-EPO)治疗早产儿贫血的临床价值及对神经行为发育的影响。方法回顾性选取2016年1月至2017年12月出生后5 d内入住首都医科大学附属北京友谊医院儿科新生儿病房并接受促红细胞生成素治疗的早产儿为观察组,其纳入标准:胎龄28～34周,体重<2 000 g,并且出生时无血液系统疾病及严重感染性及先天性疾病。按照1︰1比例匹配同期住院的早产儿为对照组,匹配条件为同性别、胎龄相差不超过1周、出生体重相差不超过200 g、出生时血红蛋白相差不超过1 g/L。最终两组患儿的出生体重、早产儿的胎龄、性别比例、(Hb)、网织红细胞(Ret)等一般资料比较,差异无统计学意义(P> 0. 05),具有可比性。对照组患儿给予常规治疗,包括补充维生素E和铁剂,必要时给予输血治疗。观察组在对照组的基础上给予r Hu-EPO治疗。比较两组患儿在治疗前后不同时间点的血常规指标[血细胞比容(Hct)、血红蛋白(Hb)、网织红细胞比率(Ret)]的差异。随访过程中根据患儿纠正胎龄40周,采用新生儿神经行为测定(NBNA)评分及脑电图检查进行评估,并比较两组结果的差异。结果观察组患儿的Hct(L/L)在治疗后1周、2周、3周、4周不同时间点指标(0. 45±0. 07; 0. 42±0. 04; 0. 39±0. 04; 0. 33±0. 03)均较对照组(0. 42±0. 03; 0. 37±0. 03; 0. 35±0. 03; 0. 30±0. 05)明显增高(P <0. 01);观察组患儿的Hb(g/L)在治疗后1周、2周、3周、4周不同时间点指标(151. 1±12. 8; 141. 4±11. 3; 134. 6±10. 3; 128. 5±12. 4)均较对照组(140. 3±11. 7; 128. 6±10. 4; 113. 7±9. 6; 107. 4±9. 4)明显增高(P <0. 01);观察组患儿的Ret(%)在治疗后1周、2周、3周、4周不同时间点指标(3. 65±0. 91; 4. 46±0. 63; 4. 55±0. 44; 4. 05±0. 84)均较对照组(2. 87±0. 55; 2. 72±0. 35; 2. 37±0. 26; 1. 98±0. 54)明显增高(P <0. 01);治疗后随访3个月采用纠正胎龄满40周方法,对照组患儿的NBN
Objective To retrospectively study the effect of recombinant human erythropoietin on anemia and neurobehavioral development in prematures.Methods Preterm infants admitted to the pediatric neonatal ward of this hospital and treated with erythropoietin within 5 days after birth during January 2016 to December 2017 were enrolled as observation group.The inclusion criteria of observation group including:gestational stage:28~34 weeks,body weight<2 000 g,and no blood system diseases and serious infection and congenital diseases at birth.According to 1∶1 ratio,the premature infants hospitalized in this department in the same period were matched as control group.The matching conditions were the same sex,the difference in gestational age within 1 week,the difference in birth weight within 200 g,and the difference in hemoglobin at birth within 1 g/L.At the end,the general data of birth weight,gestational age,gender ratio,Hb,Ret and so on of these two groups were compared without statistical significance(P>0.05).The erythropoietin was used in observation group on the basis of conventional therapy,conventional treatment including vitamin E and iron supplements,and blood transfusion if necessary it was applied in control group.The difference in blood routine indexes[erythrocyte specific volume(Hct),hemoglobin(Hb),reticulocyte count(Ret)]at different time points before and after treatment were compared between these two groups.During the follow-up period,neonatal behavioral and neurological assessment(NBNA)scores and electroencephalogram(EEG)were used to evaluate the correction of gestational age at 40 weeks,and the difference between these two groups was compared.Results The value of Hct(%)of these children(0.45±0.07;0.42±0.04;0.39±0.04;.33±0.03)in observation group at different time points(1,2,3 and 4 weeks after treatment)was significantly better than those of control group(0.42±0.03,0.37±0.03,0.35±0.03,0.30±0.05)(P<0.01).The value of Hb(g/L)of children(151.1±12.8;141.4±11.3;134.6±10.3;128.5±12.4)in observatio
作者
王新佳
徐俊梅
魏田力
WANG Xin-jia;XU Jun-mei;WEI Tian-li(Department of Pediatrics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China.)
出处
《临床和实验医学杂志》
2019年第9期949-951,共3页
Journal of Clinical and Experimental Medicine
关键词
早产儿
重组人促红细胞生成素
贫血
神经行为发育
Premature children
Recombinant human erythropoietin
Anemia
Neurobehavioral development
