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目的探讨不同剂量促红细胞生成素对早产儿神经系统发育的影响。方法研究对象为2013年9月-2015年10月期间该院出生的141例早产儿,采用双盲法随机分为常规组、小剂量组、大剂量组,每组患儿人数均为47例。其中常规组给予一般治疗,小剂量组加用小剂量促红细胞生成素,大剂量组患儿加用大剂量促红细胞生成素,对治疗前、胎龄40周后患儿进行神经行为(NBNA)评分,随访1年对婴幼儿半年、1年智能发育进行评估,对治疗前后患儿白细胞介素-6(IL-6)、中枢神经特异蛋白(S100β)水平变化进行检测。结果随访1年期间,小剂量组、大剂量组患儿智能发育优于常规组,且大剂量组患儿智能发育较小剂量组好,差异有统计学意义(均P<0.05);治疗前,患儿NBNA评分、S100β、IL-6水平比较差异无统计学意义(P>0.05),治疗后,小剂量组、大剂量组患儿NBNA评分高于常规组,同时大剂量组患儿NBNA评分高于小剂量组,小剂量组、大剂量组患儿S100β、IL-6水平恢复优于常规组,同时大剂量组患儿S100β、IL-6水平恢复优于小剂量组,差异有统计学意义(均P<0.05)。结论临床对早产儿使用促红细胞生成素治疗,能有效防治脑损伤,同时大剂量此药保护神经效果优于小剂量。
Objective To investigate the effects of different doses of erythropoietin on the development of nervous system in premature infants. METHODS: The 141 preterm infants born in our hospital from September 2013 to October 2015 were randomly divided into routine group, low dose group and high dose group by double-blind method. The number of children in each group was 47 . The conventional treatment group was given general treatment, the low-dose group plus low-dose erythropoietin, and the high-dose group plus high-dose erythropoietin. Neonatal behavior (NBNA) Score, followed up for 1 year to evaluate the infant’s half-year and 1-year intelligent development. The levels of interleukin-6 (IL-6) and S100β in the children before and after treatment were measured. Results During the follow-up period of 1 year, the intelligence development of the low-dose group and the high-dose group was better than that of the conventional group, and the high-dose group was better than the low-dose group in intelligence development (all P <0.05) , NBNA score, S100β, IL-6 levels in children had no significant difference (P> 0.05). After treatment, the NBNA scores of children in low-dose group and high-dose group were higher than those in normal group The scores of S100β and IL-6 in children of high-dose group and low-dose group were higher than those of low-dose group, and the levels of S100β and IL-6 in high-dose group were better than those in low-dose group Significance (both P <0.05). Conclusions The clinical use of erythropoietin in preterm infants can effectively prevent and treat brain injury. At the same time, the neuroprotective effect of large dose of this drug is better than that of low dose.