rhG-CSF治疗早产儿中性粒细胞减少症的临床疗效

Clinical efficacy of rhG-CSF in the treatment of premature neutropenia

目的:研究早产儿中性粒细胞减少症的危险因素,并进一步探究重组人粒细胞刺激因子(rhG-CSF)辅助治疗35周以下早产儿中性粒细胞减少症的临床疗效。方法:回顾性分析227例早产儿住院资料,根据有无中性粒细胞减少症分为两组,采用Logistic回归分析早产儿中性粒细胞减少症的危险因素。76例胎龄小于35周早产儿合并中性粒细胞减少症,根据是否使用rhG-CSF治疗分为两组,对照组未使用rhG-CSF,治疗组使用rhG-CSF治疗,比较两组临床疗效。结果:多因素Logistic回归分析显示胎龄、出生体质量、围生期感染、妊娠期高血压均是早产儿中性粒细胞减少症的危险因素(OR>1,P<0.01)。rhG-CSF治疗组患儿腹胀、黄疸持续时间、住院时间、抗菌药物及呼吸机使用时间均短于对照组(P<0.05)。入院第7天治疗组血白细胞计数、中性粒细胞绝对值计数水平显著高于对照组(P<0.05)。结论:胎龄、出生体质量、围生期感染、妊娠期高血压是早产儿中性粒细胞减少症的危险因素。rhG-CSF辅助治疗中性粒细胞减少症能有效提高血白细胞计数及中性粒细胞绝对值水平,缩短疗程,改善临床症状。

Objective:To study the risk factors of neutropenia in preterm infants,and further explore the clinical efficacy of recombinant human granulocyte stimulating factor(rhG-CSF)in the adjuvant treatment of preterm infants with neutropenia less than 35 weeks.Methods:The clinical data of 227 premature infants were retrospectively collected and divided into two groups according to the presence or absence of neutropenia.76 premature infants of gestation age less than 35 weeks diagnosed with neutropenia were divided into two groups according to whether the rhG-CSF treatment was performed.The control group was given conventional treatment,and the treatment group was additionally treated with rhG-CSF.The clinical efficacy of the two groups was compared.Results:Multivariate logistic regression analysis showed that gestational age,birth weight,neonatal infection,and maternal hypertension were risk factors for neutropenia in preterm infants(OR>1,P<0.01).The duration of abdominal distension and jaundice,hospitalization,and the use of antibiotics and ventilator in treatment group were shorter than those in control group(P<0.05).On the 7th day of admission,the WBC count and neutrophil absolute value in treatment group were significantly higher than those in control group(P<0.05).Conclusion:Small gestational age,low birth weight,infection,and gestational hypertension are risk factors of neutropenia in preterm infants,and the adjuvant treatment of neutropenia can effectively improve the white blood cell count and neutrophil absolute value level,shorten the course of treatment,and improve the clinical symptoms.