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目的探讨不同剂量促红细胞生成素(rhEPO),对早产儿神经系统发育的影响。方法入住本院NICU病房的早产儿,按入院先后次序分为rhEPO组(治疗组)和对照组,其中治疗组120例,对照组30例,其中rhEPO治疗组又随机分为3组,低剂量组(750 U·周·kg~(-1)),中等剂量组(1 500 U·周·kg~(-1)),高剂量组2 000 U·周·kg~(-1))。比较2组早产儿在纠正胎龄40周时的新生儿神经行为测定(NBNA)评分和6,12月时的Gesell发育量表的评估得分。结果 rhEPO组NBNA评分显著高于对照组,中等剂量和高剂量组分别优于低剂量组(P<0.05),中等剂量和高剂量组无明显差异;生后6个月时rhEPO组优于对照组大运动和适应能力,12个月时大运动、语言能力及精细动作得分实验组亦高于对照组(P<0.05)。结论早期使用大剂量EPO可显著改善早产儿预后,促进其神经系统发育。
Objective To investigate the effects of different doses of erythropoietin (rhEPO) on the development of nervous system in premature infants. Methods Preterm infants admitted to NICU ward of our hospital were divided into rhEPO group (treatment group) and control group according to the order of hospital admission, including 120 cases in the treatment group and 30 cases in the control group. The patients in the rhEPO treatment group were also randomly divided into 3 groups. Group (750 U · week · kg -1), medium dose group (1 500 U · week · kg -1) and high dose group (2 000 U · week · kg -1). The Neonatal Behavioral Neonatal Behavior (NBNA) score at 40 weeks of gestational age correction and the Gesell Development Scale score at 6 and 12 months were compared between two groups of preterm infants. Results The NBNA score of rhEPO group was significantly higher than that of the control group. The medium and high dose groups were superior to the low dose group (P <0.05), while the medium and high dose groups had no significant difference. The rhEPO group was superior to the control group at 6 months Group exercise and adaptability, 12 months of large-scale exercise, language ability and fine motor score test group also higher than the control group (P <0.05). Conclusion Early use of high-dose EPO can significantly improve the prognosis of preterm children and promote their nervous system development.