促红细胞生成素治疗新生儿缺氧缺血性脑病的疗效观察

doi:10.6040/j.issn.1671-7554.0.2015.1200

摘要/Abstract

摘要： 目的观察促红细胞生成素(EPO)治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法 81例HIE患儿随机分为治疗组(42例)和对照组(39例)。同时选取同一时期健康足月儿43例作为正常组。对照组及治疗组患儿均给予常规治疗;EPO治疗组在常规治疗的基础上,给予静脉注射EPO每日200 IU/kg,每周3次,每6天查血常规1次,根据血常规结果调整EPO剂量,疗程为2周。所有患儿于生后的7、14、28 d进行新生儿行为测定(NBNA),生后的3个月和6个月进行婴幼儿智能发育评估(CDCC)。并于生后6个月和12个月进行随访。结果生后7 d的NBNA评分治疗组与对照组无统计学差异,均低于正常组(P<0.01);14、28 d时治疗组NBNA评分均高于对照组(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)。结论应用EP0治疗新生儿HIE疗效较好,优于对照组治疗。

关键词: 促红细胞生成素, 新生儿, 缺氧缺血性脑病

Abstract: Objective To observe the curative effect of erythropoietin(EPO)in the treatment of neonatal hypoxi-ischemic Encephalopathy(HIE). Methods A total of 81 cases of neonatal HIE were randomly divided into EPO treatment group(n=42)and control group(n=39), and healthy full-term neonates born during the same period were randomly selected as the normal control group. The control group and treatment group were given conventional treatment. Besides that, the EPO treatment group was intravenously injected with EPO 200 IU/kg a day, 3 times a week for 2 weeks. All patients undertook neonatal behavior neurological determination(NBNA)on day 7, 14 and 28 after birth, and received infant intelligence development assessment(CDCC)3 and 6 months after birth. All babies were followed up 6 and 12 months after birth. Results The NBNA score 7 days after birth had no statistical difference between the treatment group and control group, which was lower than that of normal group(P<0.01). The treatment group had higher NBNA scores 14 and 28 days than the control group(P<0.05), which were still lower than those of the normal group(P<0.01). The treatment group had higher CDCC score 3 months after birth than the control group(P<0.05), which was lower than that of the normal group(P<0.01). Six months after birth, the CDCC score of the treatment group was significantly higher than that of the control group(P<0.05), and there was no difference between the normal group and normal group in MDI, but the PDI of the treatment group was still lower than that of the normal group(P<0.05). 山东大学学报 (医学版)54卷4期 -朱静,等.促红细胞生成素治疗新生儿缺氧缺血性脑病的疗效观察 \=- Conclusion The efficacy of EP0 works more effectively than ganglioside therapy in treatment of neonatal HIE.

Key words: Hypoxic-ischemic encephalopathy, Neonate, Erythropoietin

中图分类号:

R725

朱静,郭爱丽,张楠,秦明明,刘立娟,朱薇薇. 促红细胞生成素治疗新生儿缺氧缺血性脑病的疗效观察[J]. 山东大学学报（医学版）, 2016, 54(4): 60-63.

ZHU Jing, GUO Aili, ZHANG Nan, QIN Mingming, LIU Lijuan, ZHU Weiwei. Effect of erythropoietin on hypoxic ischemic encephalopathy in neonates[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(4): 60-63.

参考文献

[1] 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, 12: 968-971.
[2] Eunson P. The long-term health, social, and financial burden of hypoxic-ischaemic encephalopathy[J]. Dev Med Child Neurol, 2015, 57(3): 48-50.
[3] Pankratova S, Kiryushko D, Sonn K, et al. Neuroprotective properties of a novel, non-haematopoietic agonist of the erythropoietin receptor[J]. Brain, 2010, 133(8): 2281-2294.
[4] Zhu L, Bai X, Wang S, et al. Recombinant human erythropoietin augments angiogenic responses in a neonatal rat model of cerebral unilateral hypoxia-ischemia[J]. Neonatology, 2014, 106(2): 143-148.
[5] 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.
[6] 金汉珍, 黄德珉, 官希吉. 实用新生儿学[M]. 3版. 北京:人民卫生出版社, 2003:766-771.
[7] 周丛乐, 宋琳琳. 新生儿缺氧缺血性脑病[M] //金汉珍, 黄德珉, 官希吉. 实用新生儿学. 3 版.北京: 人民卫生出版社, 2004:770.
[8] 邵肖梅. 早产儿脑损伤和脑性瘫痪[J]. 实用儿科临床杂志, 2003, 3: 163-165.
[9] 范存仁. 婴幼儿智能发育测验手册[M]. 北京: 团结出版社, 1998: 24.
[10] Jackevicius CA, Fan CS, Warner A. Clinical outcomes of erythropoietin use in heart failure patients with anemia of chronic kidney disease[J]. J Card Fail, 2014, 20(5): 327-333.
[11] Alexander ML, Hill CA, Rosenkrantz TS, et al. Evaluation of the therapeutic benefit of delayed administration of erythropoietin following early hypoxic-ischemic injury in rodents[J]. Dev Neurosci, 2012, 34(6): 515-524.
[12] Nguyen AQ, Cherry BH, Scott GF, et al. Erythropoietin:powerful protection of ischemic and post-ischemic brain[J]. ExpBiol Med(Maywood), 2014, 239(11): 1461-1475.
[13] Fang AY, Gonzalez FF, Sheldon RA, et al. Effects of combination therapy using hypothermia and erythropoietin in a rat model of neonatal hypoxia-ischemia[J]. Pediatr Res, 2013, 73(1): 12-17.
[14] Traudt CM, McPherson RJ, Bauer LA, et al. Concurrent erythropoietin and hypothermia treatment improve outcomes in a term nonhuman primate model of perinatal asphyxia[J]. Dev Neurosci, 2013, 35(6): 491-503.
[15] Fan X, van Bel F, van der Kooij MA, et al. Hypothermia and erythropoietin for neuroprotection after neonatal brain damage[J]. Pediatr Res, 2013, 73(1): 18-23.
[16] Stohlawetz PJ, Dzirlo L, Hergovich N, et al. Effects of erythropoietin on platelet reactivity and thrombopoiesis in humans[J]. Blood, 2000, 95(9): 2983-2989.
[17] Zhu C, Kang W, Xu F, et al. Erythropoietin improved neurologic outcomes in newborns with hypoxic-ischemic encephalopathy[J]. Pediatrics, 2009, 124(2): 218-226.
[18] Jantzie LL, Miller RH, Robinson S. Erythropoietin signaling promotes oligodendrocyte development following prenatal systemic hypoxic-ischemic brain injury[J]. Pediatr Res, 2013, 74(6): 658-667.
[19] Li J, Guo W, Xiong M, et al. Effect of SDF-1/CXCR4 axis on the migration of transplanted bone mesenchymal stem cells mobilized by erythropoietin toward lesion sites following spinal cord injury[J]. IntJ Mol Med, 2015, 14. doi: 10.3892/ijmm.2015.2344.[Epub ahead of print] PubMed PMID: 26398409.
[20] Wang X, Chen Y, Kuang D, et al. The cardioprotective effects of erythropoietin in myocardial ischemic injury via upregulation of SDF-1 by JAK2/STAT3[J]. Int J Cardiol, 2012, 156(3): 320-322.

相关文章 15

[1]	陈栋,李晓莺,马静,王云峰,张文. 电子支气管镜在新生儿呼吸困难诊疗中的应用[J]. 山东大学学报（医学版）, 2016, 54(8): 84-87.
[2]	洪海洁,孙文娟,张媛,徐永萍. 足月选择性剖宫产分娩新生儿不良结局的影响因素[J]. 山东大学学报（医学版）, 2016, 54(5): 56-61.
[3]	臧丽娇,仇杰,庄根苗,安丽. 血清S100B蛋白、神经元特异性烯醇化酶与新生儿低血糖脑损伤的相关性[J]. 山东大学学报（医学版）, 2016, 54(4): 51-54.
[4]	庄根苗,唐玲,臧丽娇,安丽. 新生儿缺氧缺血性脑病中血清前白蛋白水平与新生儿行为神经测定的相关性[J]. 山东大学学报（医学版）, 2016, 54(12): 37-40.
[5]	高南南, 陈栋, 于永慧, 张丽丽. 血清生物学标志物在新生儿坏死性小肠结肠炎手术评估中的价值[J]. 山东大学学报（医学版）, 2015, 53(6): 73-76.
[6]	和振芬. 提高新生儿采血标本成功率和质量的方法探讨[J]. 山东大学学报（医学版）, 2014, 52(Z1): 146-146.
[7]	刘剑敏. 茵栀黄注射液灌肠联合培菲康口服治疗新生儿黄疸的疗效观察[J]. 山东大学学报（医学版）, 2014, 52(S1): 57-58.
[8]	芦红伟. 新生儿低钠血症50例临床观察[J]. 山东大学学报（医学版）, 2014, 52(S1): 63-64.
[9]	包菊, 曲元, 王东信. 生物节律对分娩镇痛孕妇分娩方式的影响[J]. 山东大学学报（医学版）, 2014, 52(7): 75-77.
[10]	孟琳琳1，王青1，李宜芳2，王芳1，王茜1，李文1，马祥兴1. MR ASL灌注成像在足月新生儿缺氧缺血性脑病诊断中的应用[J]. 山东大学学报（医学版）, 2014, 52(2): 65-68.
[11]	王福1，刘善文1，李彬2，耿海华3，孙帅1，李睿1，肖洁1，季晓平1 . rhEPO对氧化应激时心肌细胞及心肌梗死后心脏的保护作用[J]. 山东大学学报(医学版), 2013, 51(7): 1-5.
[12]	成锴1,2，张林娜1，孙明2，侯茜2，张敏2，杨海霞2. 773例早产儿视网膜病变筛查结果分析[J]. 山东大学学报(医学版), 2011, 49(9): 149-152.
[13]	王娜，孙正芸，王合丽，林霞，刘彦娥. 妊娠糖尿病母亲新生儿及健康巨大儿血糖、胰岛素和皮质醇水平的变化[J]. 山东大学学报(医学版), 2011, 49(6): 8-.
[14]	李峰，朱薇薇，王学燕，苏桂云. 新生儿先天性巨大血管瘤伴血小板减少综合征致弥漫性血管内凝血1例[J]. 山东大学学报(医学版), 2011, 49(5): 160-162.
[15]	王合丽1，孙学梅2，孙正芸1，王娜1，林霞1. 妊娠期糖尿病母亲新生儿T细胞亚群及NK细胞活性的变化及其与血糖相关的研究[J]. 山东大学学报(医学版), 2011, 49(4): 4-.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed