皮下注射重组人促红细胞生成素治疗早产贫血患儿的效果及对神经行为发育影响

The effect of subcutaneous injection of recombinant human erythropoietin on prematurechildren with anemia and its influence on neurobehavioral development

目的探究皮下注射重组人促红细胞生成素治疗早产贫血患儿的效果及对神经行为发育影响。方法选择2017年2月—2020年7月本院收治的188例早产贫血患儿的临床资料进行回顾性分析,按照治疗方案将其分为研究组和对照组两组,每组各94例。对照组采用常规治疗,研究组在对照组基础上皮下注射重组人促红细胞生成素(rh-EPO)治疗,比较两组患儿贫血改善状况及对神经行为发育等影响,对两组患儿治疗前后血清炎症因子进行检测[白细胞介素-17(Interleukin-17,IL-17)及白细胞介素-23(Interleukin-23,IL-23)],记录不良反应发生情况。结果治疗后,两组网织红细胞计数(Ret)较治疗前均升高,研究组高于对照组(P<0.05);治疗后,红细胞比容(Hct)及血红蛋白(Hb)较治疗前均降低,研究组低于对照组(P<0.05);研究组治疗后输血例数少于对照组(P<0.05);治疗后,两组患儿格塞尔发育量表(Gesell)及神经学评估(NBNA)评分较治疗前均明显升高(P<0.05),观察组高于对照组(P<0.05)。治疗前,两组患儿的IL-17水平及IL-23水平比较无统计学差异(P>0.05);治疗后,两组患儿的IL-17水平及IL-23水平较治疗前均降低(P<0.05),且研究组均低于对照组(P<0.05);两组患儿均未出现严重不良反应。结论rh-EPO治疗早产贫血患儿,可有效改善贫血症状及神经功能,促进神经行为发育,并降低患儿体内IL-17水平及IL-23水平。

Objective To explore the effect of subcutaneous injection of recombinant human erythropoietin on prematurechildren with anemia and its influence on neurobehavioral development.Methods A retrospective analysis on the clinical data of 188 prematurechildren with anemia those were admitted to our hospital from February 2017 to July 2020 wasconducted.The patients were divided into a study group and a control group according to treatment schedule,with 94 cases in each group.The control group was given conventional treatment,and the study group received subcutaneousinjection of recombinant human erythropoietin(rh-EPO)on the basis of the control group.The improvement of anemia and the influence on neurobehavioral development in the two groups were compared.Serum inflammatory factors[Interleukin-17(IL-17)and Interleukin-23(IL-23)]in the two groups of childrenwere detected before and after treatment,and adverse reactions were recorded.Results After treatment,the reticulocyte count(Ret)of the two groups were higher than those before treatment,and the study group was higher than that of the control group(P<0.05).After treatment,hematocrit(Hct)and hemoglobin(Hb)in both two groups were decreased compared withthose before treatment,the study group was lower than the control group(P<0.05).The number of blood transfusions in the study group after treatment was less than the control group(P<0.05).After treatment,the scores of Gesell development scale(Gesell)and neonatal behavioral neurological assessment(NBNA)scale were significantly higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).Before treatment,there were no significant difference in the levels of IL-17 and IL-23 between the two groups(P>0.05).After treatment,the levels of IL-17 and IL-23 in the two groups were lower than before treatment(P<0.05),and the study group was lower than the control group(P<0.05),there were no serious adverse reactions in the two groups.Conclusions rh-EPO treatment for children with premature anemia could effectively improve anemia symptoms and neurological function,and promote neurobehavioral development,and reduce the levels of IL-17 and IL-23 in children.