促红细胞生成素在早产儿贫血中的防治作用

The effects of recombinant human erythropoietin on anemia of preterm infants

目的观察重组人类促红细胞生成素(recombinant human erythropoietin,r h-EPO)在早产儿贫血中的防治作用。方法将早产后在我科住院的胎龄小于34w,体重低于2000g的新生儿50例,按入院顺序随机分成两组,治疗组25例,对照组25例。两组患儿入院后常规给予保暖,维持体温、血糖、血压等内环境稳定,营养支持等处理,必要时输血。治疗组于生后第7天开始给予重组人类促红细胞生成素200IU/kg.d,皮下注射,每周3次,共4w。对照组仅用常规治疗。分别于生后第1、2、3、4、5w抽取外周静脉血,检测并比较不同时间两组早产儿的血红蛋白(haemoglobin,HB)、网织红细胞(reticulocyte,Ret)和血细胞比容(hematocrit,HCT)。结果两组早产儿出生后血红蛋白均下降,但治疗组下降缓慢,治疗结束后两组差异非常显著(P<0.01);治疗组治疗后网织红细胞计数和血细胞比容较对照组明显升高(P<0.01);治疗结束后两组网织红细胞计数差异缩小(P>0.05),但血细胞比容差别仍显著(P<0.01);治疗组的输血率(8%)较对照组的输血率(32%)明显减少(P<0.05)。结论重组人类促红细胞生成素可以有效的防治早产儿贫血,减少输血。

Objective ： To discuss the effect of recombinant human erythropoietin （ r h - EPO） in prevention and treatment of anemia of prematurity. Methods ： 50 preterm infants who admitted hospital after premature delivery were randomly enrolled in this study ： treated group （25 neonates） and control group （25 neonates）, theirs gestation ages less than 34 weeks and the birth weight less than 2000g. They were routinely kept body warm, serum glucose and blood pressure in normal levels and were nutritional supported, sometimes, the blood transfusion are introduced, r h - EPO 200 IU/kg·d was given to the treated group thrice - weekly by subcutaneous injection, one time every 2 days for 4 weeks from the 1 st week of life. The control group is simple routinely treated. The level of serum haemoglobin （ HB）, hematocrit （HCT） and reticulocyte （Ret） were detected on 1st week, 2nd week, 3rd week, 4th week and 5th week after birth. Results： The levels of HB in both of these two groups are decreased, but the speed of decreasing in the treated group is slower than the control group, the difference is significant between the two groups to the treatment end （ P 〈 0. 01 ）. The HCT and Ret of treated group were increased significantly compared with control group （ P 〈0. 01 ）. To the end, the difference of Ret is small （ P 〉0. 05）, but the difference of HCT is still obvious between the two groups （ P 〈0.01 ）. The need for transfusion in the treated group was significantly less than that in the control group （ P 〈 0.05 ）. Conclusion： r h - EPO can efficiently prevent and treat anemia of prematurity and decrease the need for transfusion.