早期大剂量EPO对早产儿脑发育的保护作用研究

Effect of Early High-Dose Recombinant Human Erythropoietin Therapy on Neurological Development in Preterm Infant

目的探讨早期大剂量人促红细胞生成素(EPO)对早产儿神经发育的保护作用。方法选取符合条件早产儿共60例,随机分为大剂量EPO治疗组和对照组,每组患儿各30例。两组患儿生后均给予常规治疗,并同时在生后1,2,3 d分别经静脉给予EPO 1000 U/kg(实验组)和250 U/kg(对照组)。比较两组早产儿在纠正胎龄40周时的新生儿神经行为测定(NBNA)评分和6,12月时的Gesell发育量表的评估得分。结果纠正胎龄40周时的NBNA评分大剂量组明显高于对照组,差异有统计学意义(P<0.05);生后6,12月对两组患儿进行Gesell发育量表评价,6个月时大运动和适应能力实验组优于对照组,12个月时大运动、语言能力及精细动作得分实验组亦高于对照组,两组相比差异有统计学意义。结论早期使用大剂量EPO可显著改善早产儿预后,促进其神经系统发育。

Objective To explore the effect of the early high-dose recombinant human erythropoietin（rhu-EPO） on neurological development in preterm infant.Methods 60 preterm infants were randomly divided into two groups,high-dose EPO treatment group and control group（n=30 each）.The high-dose EPO treatment group received intravenous rhu-EPO（1000 U/kg,3 times） and control group received rhu-EPO（250 U/kg,3 times） from postnatal day 1,2,3.The score of Neonatal Behavioral Neurological Assessment（NBNA） at 40 weeks of corrected gestational age and the score of Gesell Development Schedule at 6 and 12 months after birth were compared.Results The NBNA score of the high-dose EPO treatment group was significantly higher than that in the control group at 40 weeks of corrected gestational age（P0.05）.The developmental score of gross motor and adaptability in the high-dose EPO treatment group was significantly higher than that in the control group at 6 months after birth（P0.05）,and the score of gross motor,fine motor and language in the high-dose group was significantly higher than that in the control group at 12 months after birth（P0.05）.Conclusion Early use of the high-dose EPO can promote neurodevelopment and remarkable improve the prognosis of the preterm infant.