不同剂量rhEPO治疗VLBWI脑损伤的研究

The Study of Different Doses rhEPO in the Treatment of VLBWI Brain Injury

目的探讨不同剂量的重组人促红细胞生成素(rh EPO)在极低出生体重儿(VLBWI)脑损伤治疗中的临床效果及安全性。方法选取2014年10月~2016年10月在本院儿科收治的确诊为脑损伤的VLBWI 118例,随机分为大剂量组45例、小剂量组43例、对照组30例。大剂量组及小剂量组在出生后7 d内分别给予rh EPO 1 000 U·kg^(-1)、500 U·kg^(-1)静脉注射,连用3 d,对照组只给予常规对症治疗。观察各组治疗效果及安全性。结果大剂量组血清中EPO、S100B、IL-6水平分别与小剂量组、对照组比较,差异有统计学意义(P<0.05);小剂量组各项指标和对照组比较,差异无统计学意义(P>0.05);大剂量组NBNA评分、6个月及12个月PDI、MDI评分分别与对照组比较,差异有统计学意义,P<0.05;各组12个月PDI、MDI评分与6个月时指标比较,差异均有统计学意义(P<0.05);大剂量组和其他两组比较,12个月时PDI、MDI改善更明显(P<0.05)。结论大剂量rh EPO在VLBWI脑损伤治疗中效果优于小剂量,且较安全,临床可以推广应用。

OBJECTIVE To investigate the clinical efficacy and safety of different doses of recombinant human erythropoietin（ rh EPO） in the treatment of very low birth weight infants（ VLBWI）. METHODS From October 2014 to October 2016,118 cases of brain injury of very low birth weight infant in our hospital,were randomly divided into 3 groups： high-dose group（ 45 cases）,low-dose group（ 43 cases） and control group（ 30 cases）. Within 7 d after birth,high-dose group and low-dose group were given rh EPO 1 000U·kg-1,500 U·kg-1intravenously for 3 d. The control group only received routine symptomatic treatment. The therapeutic effect and safety were observed. RESULTS The levels of EPO,S100 B and IL-6 in serum of high-dose group were significantly different with those of control group（ P〈0.05）; there was no significant difference between the low-dose group and the control group（ P〉0.05）; NBNA score,6 months and 12 months PDI,MDI scores of high-dose group were significantly different with those of the control group（ P〈 0.05）; the PDI score and MDI score of 12 months were significantly different with those of 6 months（ P 〈0.05）; 12 months PDI,MDI improvement of the high-dose group was more obvious than those of the other two groups（ P 〈 0. 05）. CONCLUSION High dose of rh EPO in the treatment of VLBWI brain injury is better than low dose. It is safe and can be widely used in clinic.