促红细胞生成素与早产儿视网膜病变关系的研究进展

Research progress on the relationship between erythropoietin and retinopathy of prematurity

随着围产医学技术的进步,早产儿的存活率已大幅提高,存活早产儿的出生胎龄和体质量也在不断降低,但早产儿视网膜病变(ROP)以及早产儿贫血的发生率也随之提高。重组人类促红细胞生成素(rhEPO)目前可被用于治疗早产儿贫血,促红细胞生成素(EPO)除能促进骨髓红细胞生成以外,还具有调节血管生成、抑制神经细胞凋亡等作用,因此,临床上在使用rhEPO治疗早产儿贫血时,另一方面可能会对ROP产生影响。EPO对ROP的影响是双方面的,既可以保护ROP,又可以加重ROP。本文就EPO与ROP关系的基础研究及临床研究作一综述,分析内源性EPO、外源性EPO、EPO不同开始用药时间和给药剂量对ROP的影响。

With the development of perinatal medicine technology,the survival rate of premature infants has been greatly improved.The birth gestational age and birth weight of viable premature infants have also been continuously reduced.However,the incidence of retinopathy of prematurity(ROP)and anemia in premature infants has also been increased accordingly.Currently,recombinant human erythropoietin(rhEPO)can be used to treat anemia in premature infants.In addition to promoting bone marrow red blood cell production,erythropoietin(EPO)can also regulate angiogenesis and inhibit apoptosis of neural cells and so on.Therefore,when rhEPO is clinically used to treat anemia in premature infants,it may affect ROP on the other hand.The impact of EPO on ROP may be two-fold,which means it can not only protect but also aggravates ROP.This review summarizes the basic research and clinical research on the relationship between EPO and ROP and analyzes the effects of endogenous EPO,exogenous EPO and different initial time and dosage of EPO on ROP.