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目的综合应用临床血液学检验指标评估重组人类促红细胞生成素(r Hu-EPO)联合葡萄糖酸亚铁防治极低出生体重早产儿贫血的临床疗效。方法将2008年10月至2010年12月收治于广东省妇幼保健院新生儿科的胎龄<35周、出生体重900~1 500 g的120例早产儿随机分为治疗组(n=60)和对照组(n=60)。治疗组于出生后2周开始使用250 U/(kg·次)的r Hu-EPO,1周2次皮下注射,连用4周,加常规治疗:铁剂6 mg/(kg·d),分3次口服、Vit E 25mg/d,必要时输血治疗;对照组未用r Hu-EPO,仅使用常规治疗。对照组和治疗组的血液标本均行血常规及网织红细胞检测。结果两组早产儿出生后血红蛋白(Hb)水平和红细胞压积(HCT)均逐渐下降,但治疗组下降幅度较对照组缓慢,两组间差异有统计学意义(P<0.01)。治疗组患儿于治疗后网织红细胞百分比(Retic%)即明显上升,与对照组相比差异有统计学意义(P<0.01)。治疗组4周内仅有6例患儿需要输血,而对照组患儿需要输血的例数为24例,两组差异有统计学意义。结论早期皮下注射r Hu-EPO联合葡萄糖酸亚铁能有效防治早产儿贫血,减轻贫血程度以及减少输血次数,利于早产儿的生长发育。
Objective To evaluate the clinical efficacy of recombinant human erythropoietin (r Hu-EPO) combined with ferrous gluconate in the prevention and treatment of anemia of very low birth weight premature infants by clinical hematology test. Methods Totally 120 preterm infants with birth weight of 900-1 500 g were randomly divided into treatment group (n = 60) and neonatal control group (n = 60) at the neonatal department of Guangdong MCH hospital from October 2008 to December 2010. Control group (n = 60). The treatment group started rHu-EPO 250 U / (kg · s) twice a week after birth and was subcutaneously injected twice a week for 4 weeks. The conventional treatment was as follows: iron 6 mg / (kg · d) 3 times orally, Vit E 25mg / d, if necessary, blood transfusions; control group without r Hu-EPO, only conventional treatment. Blood samples of control group and treatment group were detected by blood routine and reticulocyte. Results The levels of hemoglobin (Hb) and hematocrit (HCT) in preterm infants decreased gradually after treatment in both groups, but the decreasing rate in treatment group was slower than that in control group. There was significant difference between the two groups (P <0.01). After treatment, the percentage of Retic% in treatment group increased significantly compared with that in control group (P <0.01). In the treatment group, only 6 patients needed blood transfusions within 4 weeks, while the number of transfusions in the control group was 24 cases, with significant difference between the two groups. Conclusion Early administration of rHu-EPO combined with ferrous gluconate can effectively prevent and treat anemia in premature infants, reduce the degree of anemia and reduce the number of transfusions, which is beneficial to the growth and development of premature infants.