促红细胞生成素对改善早产儿脑损伤的效果研究

Study on the effect of erythropoietin on improving brain injury in preterm infants

目的探讨重组人类促红细胞生成素（EPO）对改善早产儿脑损伤的临床疗效。方法将脑损伤的45例早产儿（男30例，女15例），随机分为治疗组（25例）和对照组（20例）。对照组给予常规治疗，治疗组除常规治疗外，在出生后即给予EPO治疗，每次500U／kg，每周3次，连续治疗3～4周。测试所有患儿纠正胎龄40周NBNA评分、血清神经元特异性烯醇化酶（NSE）、S-100B浓度，监测并比较两组患儿血红蛋白（Hb）、网织红细胞（Ret）和血小板（PLT）、肝肾功能等指标。结果①治疗组NBNA评分正常率为79．81％，高于对照组（38．00％），差异有统计学意义（P〈0．05）；②治疗组入院第3、7天血清NSE和S-100B均明显低于对照组，差异有统计学意义（均P〈0．05）；③生后3、6个月治疗组MDI[（91．65±6．37）、（96．70±7．34）分]、PDI评分[（87．10±5．56）、（95．80±5．33）分]均高于对照组[MDI：（81．06±10．71）、（87．00±9．37）分；PDI：（81．88±6．68）、（89．69±8．08）分[，差异有统计学意义（P〈0．05或P〈0．01）；④治疗2周后EPO治疗组Hb、Ret水平p（168．30±20．80）g／L、（3．95±0．80）％]明显高于对照组[（150．16±15．14）g／L、（2．66±0．51）％[，差异有统计学意义（P〈0．05）；两组患儿PLT水平及肝肾功能等指标均在正常范围，差异均无统计学意义（P〉0．05）。结论EPO可保护受损伤神经细胞，促进神经系统损伤修复，在改善早产儿脑损伤预后方面有着积极的作用。

Objective To study the clinical effects of recombinant human erythropoietin （EPO） in the improvement of the brain injury in preterm infants. Methods 45 infants with brain damage （30 male and 15 female） were randomly divided into treatment group （25 cases） and control group （20 cases）. The control group was given conventional treatment, treat- ment group was given conventional medical treatment in addition, that EPO treatment was offered after the birth 500 U/ kg at a time, 3 times a week, 3-4 weeks of continuous treatment. The NBNA scoring for children with corrected gesta- tional age 40 weeks, serum neuron-specific enolase （NSE）, S-100B concentration, hemoglobin （Hb）, reticulocytes （Ret） and platelets （PLT）, kidney and liver function and so on were monitored and compared. Results ①The normal rate of NBNA scoring in treatment group was 79.81%, which was higher than that of the control group （38.00%）, the difference was statistically significant （P 〈 0.05）; ②the serum NSE and S-100B of treatment group in the 3 and 7 days after treatment were obviously lower than those of the control group, the differences were statistically significant （all P 〈 0.05）; ③postnatally 3 and 6 months the MDI[（91.65±6.37）, （96.70±7.34）scores] and PDI scores [（87.10±5.56）, （95.80± 5.33） scores] of treatment group were higher than those of control group [MDI： （81.06±10.71）, （87.00±9.37） scores; PDI： （81.88±6.68）, （89.69±8.08） scores], the differences were statistically significant （P 〈 0.05 or P 〈 0.01）; ④）2 weeks after treatment, the Hb and Ret level of treatment group [（168.30±20.80） g/L, （3.95±0.80）%] were obviously higher than those of control group [（150.16±15.14） g/L, （2.66±0.51）%], the differences were statistically significant （all P 〈 0.05）, the PLT level and the liver kidney function indicators index of the two group were in normal range, there was no statis- tically significant difference （P 〉 0.05）. Conclusion EPO can protect injury nerve ceils, promote the repair of nervous system injury, and which has a positive role to improve the prognosis of brain injury in preterm infants.