重组人促红细胞生成素对极低出生体重儿神经智能发育的影响

蔡岳鞠; 宋燕燕; 黄志坚; 李坚; 吕俊健; 王晓杰; 齐俊冶

doi:10.7499/j.issn.1008-8830.2013.12.006

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中国当代儿科杂志 ›› 2013, Vol. 15 ›› Issue (12) : 1064-1067. DOI: 10.7499/j.issn.1008-8830.2013.12.006

新生儿疾病专题

重组人促红细胞生成素对极低出生体重儿神经智能发育的影响

蔡岳鞠, 宋燕燕, 黄志坚, 李坚, 吕俊健, 王晓杰, 齐俊冶

作者信息 +

Effects of recombinant human erythropoietin on neurointelligence development in very low birth weight infants

CAI Yue-Ju, SONG Yan-Yan, HUANG Zhi-Jian, LI Jian, LV Jun-Jian, WANG Xiao-Jie, QI Jun-Ye

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摘要

目的评估早期给予重组人促红细胞生成素（rhEPO）对极低出生体重儿（VLBWI）神经智能发育的临床疗效。方法选取VLBWI 78例，根据患儿父母的选择分为rhEPO治疗组（n=35）与对照组（n=43）。治疗组生后4~5 h内给予rhEPO（250 IU/kg，每周3次，连用4周）。纠正胎龄40周时行新生儿神经行为检测（NBNA），纠正胎龄3月、6月、12月时进行Gesell发育量表评估，并比较纠正胎龄6月时脑干诱发电位（ABR）及头颅B超的异常率。结果治疗组纠正胎龄40周的NBNA评分高于对照组（P<0.05）。治疗组纠正胎龄3月时的适应能力优于对照组，纠正胎龄6月时的大运动、适应能力、社交能力优于对照组，纠正胎龄12月时的大运动、适应能力、精细动作、社交能力、语言明显优于对照组，差异均具有统计学意义（均P<0.05）。治疗组纠正胎龄6月时的ABR异常率、头颅B超异常率明显低于对照组（P<0.05）。结论早期rhEPO治疗可以促进VLBWI神经系统症状早期恢复，改善患儿的认知、运动及语言能力，对神经系统具有一定的保护作用。

Abstract

Objective To evaluate the clinical effects of the early use of recombinant human erythropoietin (rhEPO) on the neurointelligence development in very low birth weight infants (VLBWI). Methods Seventy-eight VLBWI were divided into rhEPO treatment group (n=35) and control group (n=43) according to the choice of their parents. Neonatal behavioral neurological assessment (NBNA) was performed at 40 weeks of corrected gestational age. The Gesell Developmental Schedules were used for neurodevelopmental evaluation at 3, 6, and 12 months of corrected age. The abnormal rates of auditory brainstem response (ABR) and cranial ultrasound were evaluated at 6 months of corrected age. Results The rhEPO treatment group had significantly higher NBNA scores at 40 weeks of corrected gestational age than the control group (P<0.05). The adaptability at 3 months of corrected age, the gross motor, adaptability, and sociability at 6 months, and the gross motor, adaptability, fine motor, sociability, and language at 12 months were significantly better in the rhEPO treatment group than in the control group (P<0.05). The abnormal rates of ABR and cranial ultrasound in the rhEPO treatment group were significantly lower than in the control group at 6 months of corrected age (P<0.05). Conclusions Early use of rhEPO can promote the early recovery of neurological symptoms and improve the cognitive, motor, and language abilities in VLBWI due to its protective effects on the nervous system.

导出引用

蔡岳鞠, 宋燕燕, 黄志坚, 李坚, 吕俊健, 王晓杰, 齐俊冶. 重组人促红细胞生成素对极低出生体重儿神经智能发育的影响[J]. 中国当代儿科杂志. 2013, 15(12): 1064-1067 https://doi.org/10.7499/j.issn.1008-8830.2013.12.006

CAI Yue-Ju, SONG Yan-Yan, HUANG Zhi-Jian, LI Jian, LV Jun-Jian, WANG Xiao-Jie, QI Jun-Ye. Effects of recombinant human erythropoietin on neurointelligence development in very low birth weight infants[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(12): 1064-1067 https://doi.org/10.7499/j.issn.1008-8830.2013.12.006

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