摘要
目的探讨促红细胞生成素(EPO)在早产儿贫血中的治疗时机,以及对不同胎龄早产儿贫血的疗效。方法选取2014年3月—2016年2月于保定市妇幼保健院新生儿科收治的贫血早产儿90例为研究对象,采用抽签法分为对照组、晚治疗组及早治疗组,各30例。早治疗组和晚治疗组分别在出生第2周、3周开始每周给予EPO750 U/kg,并在应用EPO 1周后给予口服铁剂至出生后5周。对照组常规治疗,仅出生第2周开始给予口服铁剂至出生后5周。分别于各组治疗前及治疗后检测血红蛋白(Hb)、血细胞比容(HCT)、网织红细胞计数(Ret)、铁蛋白(SF)、叶酸、维生素B_(12)水平,记录各组治疗期间输血治疗例数。结果治疗后,晚治疗组Hb、HCT、Ret水平高于对照组,早治疗组Hb、HCT、Ret水平高于对照组、晚治疗组(P<0.05)。晚治疗组与早治疗组叶酸、维生素B_(12)治疗前后差值比较无差异(P>0.05),而早治疗组SF治疗前后差值高于晚治疗组(P<0.05)。早治疗组中,大胎龄儿与小胎龄儿治疗后叶酸、维生素B_(12)水平比较无差异(P>0.05),而大胎龄儿Hb、HCT、Ret、SF水平高于小胎龄儿(P<0.05)。治疗期间,对照组、晚治疗组、早治疗组输血率分别为63.3%(19/30)、43.3%(13/30)、36.7%(11/30),差异无统计学意义(P=0.099)。早治疗组中,小胎龄儿输血率(6/15)与大胎龄儿(5/15)比较,差异无统计学意义(P>0.05)。结论出生第2周早期应用EPO可改善早产儿贫血程度,且对大胎龄儿的治疗效果优于小胎龄儿,但尚不能完全避免输血。
Objective To investigate the therapeutic time of erythropoietin（ EPO） in anemia of prematurity and the effect on anemia of premature infants with different gestational ages. Methods From March 2014 to February 2016,90 cases of premature infants with anemia admitted to Department of Neonatology,Baoding Maternal and Child Health Hospital were selected as study objects. The patients were divided into control group,late treatment group and early treatment group using the lottery method,30 cases in each group. The early treatment group and the late treatment group were given EPO 750 U·kg^（-1）·w^（-1）2 weeks and 3 weeks after birth,respectively. And oral iron was given 1 week after the application of EPO till 5 weeks after birth.The control group received regular treatment and was given oral iron 2 weeks after birth till 5 weeks after birth. Hb,hematocrit（ HCT）,reticulocyte count（ Ret）,ferritin（ SF）,folic acid and vitamin B_（12） levels of each group were measured before and after treatment. The number of patients accepted blood transfusion during treatment in each group were recorded. Results After treatment,levels of Hb,HCT and Ret in late treatment group were higher than those in control group,and levels of Hb,HCT and Ret in early treatment group were higher than those in control group and late treatment group（ P〈0. 05）. There were no statistically significant differences in the folic acid and vitamin B_（12） difference before and after treatment between early and late treatment group（ P〈0. 05）,while the SF difference before and after treatment in early treatment group were higher than those in late treatment group（ P〈0. 05）. In early treatment group,there were no statistically significant differences in the levels of folic acid and vitamin B_（12） between big and small gestational age infants（ P〈0. 05）,while the levels of Hb,HCT,Ret,SF in infants with big gestational age were higher than those in infants with small gestational age（ P〈0. 05）. The blood transfusion rate was 63. 3%（ 19/30）,43. 3%（ 13/30） and 36. 7%（ 11/30） during treatment in the control group,late treatment group and early treatment group,respectively. And there were no statistically significant differences in the blood transfusion rate among each group（ P = 0. 099）. There was no statistically significant difference in the blood transfusion rate between small（ 6/15） and big（ 5/15） gestational age infants in the early treatment group（ P〈0. 05）. Conclusion Early application of EPO 2 weeks after birth can alleviate the degree of anemia in premature infants,and the treatment effect on big gestational age infants is better than that on small gestational age infants,but blood transfusion can not be completely avoided.
出处
《中国全科医学》
CAS
北大核心
2017年第32期3991-3995,共5页
Chinese General Practice
关键词
贫血
婴儿
早产
红细胞生成素
血红蛋白
输血
Neonatology
lottery method
regular treatment
big gestational age
blood transfusion
