重组人类促红细胞生成素治疗极低出生体重早产儿贫血的近期疗效观察

Therapeutic Effects of Recombinant Human Erythropoietin on Anemia of Prematurity in Very Low Birth Weight Infants

目的 应用重组人类促红细胞生成素 (rhu EPO)治疗极低出生体重早产儿贫血并随访至出生后 4个月 ,观察其疗效。方法 将 5 6例极低出生体重早产儿按随机抽样原则分为对照组 (2 6例 )、治疗组 (30例 )。治疗组于生后第 8天即予rhu EPO ,每次 30 0IU/kg ,皮下注射 ,每周 2次 ,共 4周 ;第 3周开始口服铁剂 (每日 5～ 10mg/kg)。两组均于生后 7d内口服维生素E(每日 5mg/kg)、叶酸片 (5mg/d)。随访至出生后 4个月。 结果 随年龄增大两组血红蛋白、红细胞数、红细胞压积均逐渐下降 ,在 7d ,14d ,2 1d ,2 8d ,35d时 ,治疗组上述指标均较对照组高 ,差异有显著性意义 (P <0 .0 1或 0 .0 5 ) ;治疗结束后 ,两组的血清铁蛋白 [(10 3± 2 5 μmol/Lvs (12 3± 2 4 )μmol/L]差异有显著性 (P <0 .0 1) ;治疗组较对照组出现贫血率低 (43%vs 89% ) ,两组比较差异有显著性 (P <0 .0 1)。结论 早期大剂量rhu EPO能减轻早产儿贫血的程度 ,可减少甚至替代输血。

Objective To study the therapeutic effects of recombinant human erythropoietin (rhu Epo) on anemia of prematurity in very low birth weight (VLBW) infants. Methods Fifty six VLBW premature infants were randomly assigned into two groups: the treated group (n=30) and the control group (n=26). The treated group received rhu Epo (300 IU/kg) twice weekly for 4 weeks by subcutaneous injection from the 8 th day of life, and was treated with oral supplement of vitamin E (5～10 mg/kg.d) from the 3 rd week of life. Oral supplement of vitamin E (5 mg/kg.d) and folic acid (5 mg/d) was given in the two groups from the 7 th day of life. They were followed up until 4 months of age. Results ①The Hb, RBC and Reticulocyte (Ret) counts in the treated group and the control group decreased gradually. There were significant differences in Hb, RBC and Ret between the two groups on the 7 th , 14 th , 21 st , 28 th and 35 th day (P< 0.01 or 0.05 ). ②After the treatment, the serum iron protein level in the treated group significantly differed from that of the control group [( 103 ± 25 μmol/L vs (123±24) μmol/L](P< 0.01 ). ③The prevalence of anemia in the treated group was obviously lower than that in the control group (43% vs 89%) (P< 0.01 ). Conclusions Early administration of high dosage rhu Epo can reduce the degree of anemia of prematurity and reduce or even replace the need of blood transfusion.