促红细胞生成素治疗新生儿缺氧缺血性脑病的疗效观察

Effect of erythropoietin on hypoxic ischemic encephalopathy in neonates

目的观察促红细胞生成素(EPO)治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法 81例HIE患儿随机分为治疗组(42例)和对照组(39例)。同时选取同一时期健康足月儿43例作为正常组。对照组及治疗组患儿均给予常规治疗;EPO治疗组在常规治疗的基础上,给予静脉注射EPO每日200 IU/kg,每周3次,每6天查血常规1次,根据血常规结果调整EPO剂量,疗程为2周。所有患儿于生后的7、14、28 d进行新生儿行为测定(NBNA),生后的3个月和6个月进行婴幼儿智能发育评估(CDCC)。并于生后6个月和12个月进行随访。结果生后7 d的NBNA评分治疗组与对照组无统计学差异,均低于正常组(P<0.01);14、28 d时治疗组NBNA评分均高于对照组(P<0.05),但仍低于正常组(P<0.01);3月龄CDCC评分(包括MDI、PDI评分)治疗组正常者比例高于对照组(P<0.05),但低于正常组(P<0.01)。6月龄CDCC评分治疗组正常者比例高于对照组(P<0.05),治疗组M DI评分正常者比例与正常组相比较,差异无统计学意义,但PDI评分正常者比例仍低正常组(P<0.05)。结论应用EP0治疗新生儿HIE疗效较好,优于对照组治疗。

Objective To observe the curative effect of erythropoietin（ EPO） in the treatment of neonatal hypoxi-ischemic Encephalopathy（ HIE）. Methods A total of 81 cases of neonatal HIE w ere randomly divided into EPO treatment group（ n = 42） and control group（ n = 39）,and healthy full-term neonates born during the same period w ere randomly selected as the normal control group. The control group and treatment group w ere given conventional treatment. Besides that,the EPO treatment group w as intravenously injected w ith EPO 200 IU / kg a day,3 times a w eek for 2 w eeks. All patients undertook neonatal behavior neurological determination（ NBNA） on day 7,14 and 28 after birth,and received infant intelligence development assessment（ CDCC） 3 and 6 months after birth. All babies w ere follow ed up 6 and 12 months after birth. Results The NBNA score 7 days after birth had no statistical difference betw een the treatment group and control group,w hich w as low er than that of normal group（ P〈0. 01）. The treatment group had higher NBNA scores14 and 28 days than the control group（ P〈0. 05）,w hich w ere still low er than those of the normal group（ P〈0. 01）.The treatment group had higher CDCC score 3 months after birth than the control group（ P〈0. 05）,w hich w as low er than that of the normal group（ P〈0. 01）. Six months after birth,the CDCC score of the treatment group w as significantly higher than that of the control group（ P〈0. 05）,and there w as no difference betw een the normal group and normal group in M DI,but the PDI of the treatment group w as still low er than that of the normal group（ P〈0. 05）.Conclusion The efficacy of EP0 w orks more effectively than ganglioside therapy in treatment of neonatal HIE.