促红细胞生成素治疗新生儿缺氧缺血性脑病疗效观察

摘要
图/表
参考文献(16)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (926 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的：通过对促红细胞生成素（EPO）治疗中度、重度新生儿缺氧缺血性脑病（HIE）的疗效观察，了解EPO对神经的保护作用及对新生儿HIE预后的影响。方法：将70例中、重度HIE新生儿随机分为治疗组（35例）和对照组（35例），其中治疗组中度HIE 22例，重度HIE 13例；对照组中度HIE 24例，重度HIE 11例；同时选取同一时期健康足月儿35例作为正常组。对照组给予常规治疗。除常规治疗外，治疗组给予静脉注射EPO 每日200 IU/kg，每周3次，每6 d查血常规1次，根据血常规结果调整EPO剂量,总疗程为2～4周。所有患儿于28日龄时进行NBNA评分，3月、6月龄时进行智能发育测评（CDCC）。结果：治疗组28日龄NBNA评分正常者比例高于对照组(P<0.05),但仍低于正常组(P<0.01)。3月龄CDCC评分（包括MDI、PDI评分）治疗组正常者比例高于对照组（P<0.05）,但低于正常组（P<0.01）。6月龄CDCC评分治疗组正常者比例高于对照组(P<0.05), 治疗组MDI评分正常者比例与正常组相比较，差异无统计学意义，但PDI评分正常者比例仍低正常组(P<0.05)。结论：EPO可保护因缺氧缺血损害的神经细胞，促进中、重度HIE新生儿大脑发育。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王英娟
	潘凯丽
	赵晓莉
	强欢
	成胜权

关键词 ：促红细胞生成素, 缺氧缺血性脑病, 新生儿

Abstract：OBJECTIVE: To study the efficacy of erythropoietinin (EPO) in the treatment of moderate or severe hypoxic-ischemic encephalopathy (HIE) in neonates. METHODS: Seventy neonates with moderate or severe HIE were randomly assigned to two groups: EPO treatment and control (n=35 each). The EPO treatment group included 22 cases of moderate HIE and 13 cases of severe HIE. The control group included 24 cases of moderate HIE and 11 cases of severe HIE. Thirty-five healthy full-term infants served as normal group. The control group received a conventional treatment. Beside the conventional treatment, the EPO treatment group was intravenously injected with EPO of 200 IU/kg?d, 3 times weekly. Routine blood test was performed every 6 days. EPO dose was adjusted based on the results of the routine blood test. The course of EPO treatment was 2 to 4 weeks. Neonatal Behavioral Neurological Assessment (NBNA) was performed at age of 28 days. The infant development test of Child Development Centre of China (CDCC) was performed at ages of 3 months and 6 months. RESULTS: The percentage of normal NBNA scores in the EPO treatment group was significantly higher than that in the control group at age of 28 days (P<0.05), but was significantly lower than that in the normal group (P<0.01). The CDCC test including physical development index (PDI) and physical development index (MDI) showed the percentage of normal results in the EPO treatment group was significantly higher than in the control group at age of 3 months (P<0.05), but was significantly lower than in the normal group (P<0.01). The CDCC test including PDI and MDI showed that the percentage of normal results in the EPO treatment group was significantly higher than in the control group at age of 6 months. The MDI test results in the EPO treatment group were not significantly different from those in the normal group at age of 6 months, but the percentage of normal results in the PDI test in the EPO treatment group was still significantly lower than that in the normal group (P<0.05). CONCLUSIONS: EPO treatment has neuroprotective effects against moderate or severe HIE and improves longterm behavioral neurological developments in neonates.

Key words： Erythropoietin Hypoxic-ischemic encephlopathy Neonate

PACS:

R722.1

引用本文:

王英娟,潘凯丽,赵晓莉等. 促红细胞生成素治疗新生儿缺氧缺血性脑病疗效观察[J]. 中国当代儿科杂志, 2011, 13(11): 855-858.

WANG Ying-Juan,PAN Kai-Li,ZHAO Xiao-Li et al. Therapeutic effects of erythropoietin on hypoxic-ischemic encephalopathy in neonates[J]. CJCP, 2011, 13(11): 855-858.

链接本文:

http://www.zgddek.com/CN/ 或 http://www.zgddek.com/CN/Y2011/V13/I11/855

	［1］Fisher JW. Erythropoietin: physiology and pharmacology update［J］. Exp Biol Med(Maywood), 2003, 228(1): 1-14.
	［2］夏桂枝,张国成.促红细胞生成素与缺氧缺血性脑损伤［J］.国外医学儿科学分册,2006, 23(1)：48-51.
	［3］中华医学会儿科学分会新生儿学组.新生儿缺氧缺血性脑病诊断标准［J］.中国当代儿科杂志,2005,7(2)：97-98.
	［4］何金水,黄仲玲,杨鸿,翁开枝,朱少波.早期应用rhuEPO对早产儿神经行为发育的影响［J］.中国当代儿科杂志,2008,10(5)：586-588.
	［5］史鸽,苏振军,王新华.促红细胞生成素对新生儿缺氧缺血性脑病的保护作用［J］.现代中西医结合杂志,2009,18(17)：1994-1995 ［6］蔡清,薛辛东,富建华.新生儿缺氧缺血性脑病研究现状及进展［J］.中国实用儿科杂志,2009,24(12)：968.
	［7］Sobh MA, el-Tantawy AE, Said E, Atta MG, Refaie A, Nagati M, et al. Effect of treatment of anaemia with erythropoietin on neuromuscular function in patients on long-term haemodialysis［J］. Scand J Urol Nephrol, 1992, 26(3): 65-69.
	［8］Spandou E, Papoutsopoulou S, Soubasi V, Karkavelas G, Simeonidou C, Kremenopoulos G, et al. Hypoxia-ischemia affects erythropoietin and erythropoietin receptor expression pattern in the neonatal rat brain［J］.Brain Res, 2004, 1021(2): 167-172.
	［9］陈宁,毛健,杜悦.新生儿缺氧缺血性脑病血清及脑脊液中促红细胞生成素的变化［J］.中国当代儿科杂志,2005,7(2)：107-110.
	［10］Konstantinopoulos PA, Karamouzis MV, Papavassiliou AG. Selective modulation of the erythropoietic and tissue-protective effects of erythropoietin: time to reach the full therapeutic potential of erythropoietin［J］. Biochim Biophys Acta, 2007, 1776(1): 1-9.
	［11］Tao WY, Wen F, Zhang H, Liua G. The signal transduction mediated by erythropoietin and proinflammatory cytokines in the JAK/STAT pathway in the children with cerebral palsy［J］. Brain Dev, 2009, 31(3): 200-207.
	［12］Semenza GL, Wang GL. A nuclear factor induced by hypoxia via de novo protein synthesis binds to the human erythropoietin gene enhancer at a site required for transcriptional activation［J］. Mol Cell Biol, 1992, 12(12): 5447-5454.
	［13］Martínez-Estrada OM, Rodríguez-Mill-n E, Gonz-lez-De Vicente E, Reina M. Erythropoietin protects the in vitro blood-brain barrier against VEGF-induced permeability［J］. Eur J Neurosci, 2003, 18(9): 2538-2544.
	［14］Mainie P. Is there a role for erythropoietin in neonatal medicine?［J］. Early Hum Dev, 2008, 84(8): 525-532.
	［15］Fu ZQ, Shao QL, Shen JL, Zhang YJ, Zhao XX, Yao L. Effect of carbamylated erythropoietin major histocompatibility complex expression and neural differentiation of human neural stem cells［J］. J Neuroimmunol, 2010, 221(1-2): 15-24.
	［16］Juul SE, McPherson RJ. Recent trends in erythropoietin-mediated neuroprotection［J］. Int J Dev Neurosci, 2008, 26(1): 103-111.
	［17］Zhou QH, Boado RJ, Lu JZ, Hui EK, Pardridge WM. Re-engineering erythropoietin as an IgG fusion protein that penetrates the blood-brain barrier in the mouse［J］. Mol Pharm, 2010, 7(6): 2148-2155.