目的 探讨大剂量重组人促红细胞生成素(EPO)对早产儿早期神经行为发育及贫血的影响.方法 将2009 年5 月至2012 年5 月入住我院的60 例早产儿随机分为对照组与观察组各30 例,两组患儿均给予常规的治疗.同时于出生后1 d、2 d、3 d 分别经静脉给予EPO 1 000 U/kg (实验组)和250 U/kg (对照组).比较两组血红蛋白(Hb)、红细胞压积(Hct)、网织红细胞计数(Ret)以及血清铁蛋白(SF)的动态变化,纠正胎龄40 周时的新生儿神经行为测定(NBNA)评分,1、3 个月时进行脑干诱发电位(ABR)检查,并比较两组患儿异常发生率.结果 (1)观察组Hb、Hct、Ret 以及SF动态变化结果均明显优于对照组,且二者差异有显著统计学意义(P<0.01);(2)在纠正胎龄满40 周时,对照组NBNA得分为(35.09±2.18)分,观察组NBNA得分为(38.52±1.69)分,两组比较差异具有统计学意义(P<0.05);1、3 个月时ABR 大剂量EPO 组异常发生率明显低于普通剂量组,差异有统计学意义(P<0.05).结论 大剂量重组人促红细胞生成素对早产儿早期神经行为发育具有重要的促进作用,且比常规剂量重组人促红细胞生成素更能够有效地预防早产儿贫血.%Objective To investigate the effect of high-dose recombinant human erythropoietin hormone on early neurobehavioral development and anemia of premature children. Methods Sixty premature children in our hospital from May 2009 to May 2011 were randomly divided into the control group and the observation group, each was 30 cases. The control group was given conventional dose (250 U/kg) EPO, and the observation group was given high-dose (1000 U/kg) EPO. Then the dynamical changes of Hb, Hct, Ret and SF, and the NBNA scores were compared between the two groups. P<0.05 indicated that there was a statistically significant difference between the two groups. The paragenesis rate of brainstem evoked potential (ABR) at 1 and 3 months after birth. Results (1) Hb, Hct, Ret and SF value in the observation group was significantly better than those in the control group (P<0.01). (2) The NBNA score was (35.09±2.18) in the control group and (38.52±1.69) in the observation group, with statistically significant difference between the two groups (P<0.05). At 1, 3 months after birth, the paragenesis rate of brainstem evoked potential (ABR) in the high-dose EPO treatment group was significantly lower than that in the control group (P<0.05). Conclusion The high-dose recombinant human erythropoietin EPO has an important role in promoting early neurobehavioral development of premature children, which is also effective in preventing anemia of premature child.
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