摘要
目的 探讨重组人类促红细胞生成素(rHu-Epo)防治早产儿贫血的疗效。方法 将52例胎龄<35周,出生体重900-2000g的适于胎龄早产儿按入院先后次序分成早期治疗组18例、后期治疗组17例、对照组17例。早期治疗组生后第1周即应用rHu-Epo500Iu.kg^(-1).w^(-1),隔日1次,每周3次,皮下注射,共5周,后期治疗组生后第3周应用rHu-Epo,用法同早期治疗组,对照组未予rHu-Epo治疗。三组患儿均于生后第2周开始口服铁剂(元素铁8mg.Kg^(-1).d^(-1))至第8周,必要时输血,共观察6月。结果 早、后期治疗组均于应用rHu-Epo2周后网织红细胞(Ret)明显升高,应用rHu-Epo3周后Ret达高峰然后渐下降,与对照组比较P<0.01。生后8周内,三组患儿Hb值均渐下降,最低Hb值早期治疗组>后期治疗组>对照组,达最低Hb值时间早期治疗组<后期治疗组<对照组;12-24周Hb值早期治疗组>后期治疗组>对照组;均为P<O.01。早期治疗组贫血率、输血率明显减少(P<0.01、P<0.05)。生后8周内早期治疗组血清铁蛋白明显下降,后期治疗组无明显变化,对照组明显升高,P<0.01。观察期未早产儿体重早期治疗组>后期治疗组>对照组,P<0.01。结论 大剂量rHu-Epo治疗能减轻早产儿贫血程度,促进早产儿的生长发育,早期应用rHu-Epo较后期应用疗效更好,可以明显减少贫血率、输血率,体内充?
Objective: To research the efficacy of erythropoietin in prevention and treatment of anemia of prematurity. Method: 52 preterm infants were randomly assigned to early receive (early treated group : 18 neonates) or late receive (late treated group : 17 neonates) or not receive (control group: 17 neonates) rHu-Epo. rHu -Epo(500Iu.kg-1 .w-1) was given three times weekly - one time every 2 days for 5 weeks from the first week of life in early treated group, the late treated group receive the same treatment from the third week of life. Three groups had oral supplement of elemental iron 8mg. Kg-1. d-1 from secondly to eighth week of life. Blood transfusion was gived if the state of the illness reguired. Result:The reticulocyte counts in both early and late treated group had marked increase after two weeks rHu - Epo treatment, and reach peak value after three weeks treatment, then the reticulocyte counts dropped littly by little. The hemoglobin of three groups were decline during postnatal eight weeks, the lowest value of Hb were as follows:the early treated group > the late treated group > the control group (P< 0.01), the time reached the lowest Hb value was as follows: the early treated group < the late treated group < the control group (P<0.01); the value of Hb from 12th to 24th week were as follows: the early treated group > the late treated group > the control group ( P < 0.01). anemia rate and blood transfusion rate of the early treated group were significantly less than the late treated group and the control group( P<0.01、P<0.05). Serum ferritin dropped more significantly in the early treated group during postnatal eight weeks, the late treated group no significantly changed, the control group significantly raised. The weight of the premature were as follows: the early treated group > the late treated group > the control group (P < 0.01) . Conclusiou: Administration of high dosage of rHu - Epo can lighten the degree of nemia and promote the growth of the premature, early treatment with rHu - Epo is better than late treatment in reduce blood transfu- sion and anemia rate.Enough iron supplementation can increase the efficacy of rHu - Epo.
出处
《海南医学》
CAS
2003年第5期21-23,共3页
Hainan Medical Journal
