促红细胞生成素治疗早产儿脑损伤疗效分析

Effects of Erythropoietin therapy on preterm infants with brain damage

目的：观察促红细胞生成素（EPO）治疗早产儿脑损伤的疗效,探讨EPO的神经保护作用及对早产儿预后的影响。方法：将33例脑损伤早产儿（男25例,女8例）,随机分为EPO治疗组（13例）和对照组（20例）。对照组给予常规治疗,EPO治疗组除常规治疗外,给予EPO治疗,每次250IU/kg,每周3次,总疗程2~4周。所有患儿专科门诊随访至6~12个月,纠正胎龄40周时行新生儿行为神经测定（NBNA）。定期行头颅MRI、头颅B超、脑电图（EEG）、脑干听觉诱发电位（ABR）检查。结果：①EPO治疗组NBNA评分正常者占76.92%,明显高于对照组（30.00%）,差异有显著性（P〈0.05）;②出生后纠正胎龄3月龄时两组间患儿ABR异常发生率比较,差异无统计学意义（P〉0.05）,随访至纠正胎龄6月龄时,EPO治疗组ABR异常发生率明显低于对照组（P〈0.05）,表明EPO治疗后期ABR异常程度减轻。结论：应用EPO可保护受损伤的神经细胞,促进早产儿神经行为发育,改善脑损伤早产儿的预后。

Objective：To explore the protective effects of erythropoietin therapy on preterm infants with brain damage and the effects on their prognosis.Methods：Thirty-three preterm infants（25 males and 7 females）were divided into two groups randomly.The EPO group（n=13） received EPO with the dosage of 250 IU/kg·time,three times a week for 2-4 weeks.The control group（n=20） treated without EPO.All routine treatments were same between the two groups.All infants were followed up until 6-12months after birth.Neonatal behavioral neurological assessment（NBNA） for all infants was assigned at 40 weeks of corrected gestational age.Brain ultrasound scan,MRI,auditory brainstem response（ABR） and electroencephalogram（EEG） were performed.Results：The EPO group counted for a normal NBNA rate of 76.92%,significantly higher than that of the control group（76.92% vs 30.00%,P 0.05）.The two groups showed no difference in abnormal ABR rate within 3 months after birth（P 0.05）.When followed up to 3-6 months after birth,the abnormal ABR rate of EPO group were significantly lower than that of the control group（P 0.05）,and the abnormal ABR rate decreased during later period of follow-up.Conclusion：EPO therapy can rehabilitate the damaged neurological system of preterm infants with brain damage,promote development of their neurobehavior and improve the prognosis.