Erythropoietin To Premature Anemia Prevention And Protection Of Brain Damage

Objective:1 To investigate the efficacy and safety of rh EPO in prevention and treatment of anemia in VLBWI and to explore the best treatment of VLBWI anemia.2 To observe the EPO cerebral protective effection of VLBWI, to seek the best way to reduce VLBWI brain damage, promote VLBWI neural development.Methods:Subjects were 60 VLBVI patients of the second hospital of Hebei medical university neonatal intensive care unit from March 2014 to March 2015. They were randomly divided into treatment group(29 cases), control group(31 cases). There were no differences in gestational age,weight, grade, basic diseases in two groups. Treatment group infants were gave rh EPO 250 U/kg three times a week for 4 weeks since birth at the same time, oral iron 2~4 mg/kg was gaven every day since two weeks after birth; Control infants had no rh EPO treatment, only on the basis of general symptomatic treatment of oral iron agent. To detect the blood routine, reticulocyte, record the amount of blood transfusion and do a cranial ultrasound examination of two groups before treatment and in 1 week, 2 weeks, 3 weeks, 4 weeks after treatment,and record the amount of blood transfusion. We gave each subject cranial ultrasound examination after birth and once every 1~2 weeks.We did the neonatal behavioral neurological assessment(NBNA) for the subjects with correct gestational age 37 weeks. According to results, we compared hemoglobin(Hb), reticulocyte(Ret),to investigate the effection of rh EPO premature anemia. Based on red blood cell number of infusion and transfusion volume, the blood transfusion rates were compared. All the data were analyzed by SPSS 21.0.All the data were shown as mean±SD or median.Count data differences adopt X2 test, test results P < 0.05 for the difference was statistically significant, P < 0.01 is significant differences. P > 0.05 is not statistically significant.Results:1 Two groups of babies with Hb are gradually decreases after born, but the treatment group was significantly lower than the control group. In 1 week, 2 weeks before and after treatment, no obvious difference was found between two gronps of Hb(P > 0.05). After3,4week,the treatment group Hb count is higher than the control group, two groups have statistical significance(P < 0.05), including 4 weeks after treatment comparing the two groups have significant difference(P < 0.01).2 Control group with Ret declined, and the treatment group with Ret gradually rise. Before and after 1 week treatment compared two groups of Ret, there was no significant difference(P > 0.05), 2, 3, 4 weeks after treatment compared with significant difference(P < 0.01).3 Treatment group with 7 cases of blood transfusion in 29 cases, except one infusion 2 times more than all infusion 1time, total of 192 ml of blood transfusion.Control group have 15 babies in 31 cases of children with blood transfusion, Each 2.33 times the average blood transfusion, with a total of 752 ml of blood transfusion.Rate of two groups of blood transfusion, blood transfusion rate is lower than the control group, treatment group which has a statistical difference(P < 0.05).4 Two groups of babies PIVH and PVL comparison:Treatment group occurred PIVH Ⅰ degrees has 16 infants, and the control group has 19 infants,Check 4 weeks after treatment, treatment group 3 babies happen PIVH Ⅰ degrees,while the control group 11 children with PIVH Ⅰ degrees,compare the incidence was statistically significant(P < 0.05).Two groups of PIVH Ⅱ. No change before and after treatment, but the treatment group is less than the control group, there was statistically difference(P < 0.05).Treatment group of children without PVL, and the control group occurred in 2 cases, because of the specimens were less, no statistical significance between two groups.5 Born in seven days, two groups of NBNA score had no significant difference(P > 0.05), treatment group corrected gestational age 37 weeks NBNA score than the control group(P < 0.01) significantly increased.Conclusions:Rh EPO can effectively prevent premature anemia,reduce the number of blood transfusion and transfusion volume, so as to reduce the risk brought by blood transfusion.The application of rh EPO significa ntly reduced the occurrence of premature infant brain injury.