| Anemia of prematurity is a hyporegenerative anemia usually appearing after the second week, reaching highest intensity in the second month of life. It's normocytic and normochromic with low reticulocyte count. It has been attributed to EPO deficiency and suggested that EPO administration in premature infants could be of benefit trying to maintain or increase the hematocrit levels. Recent study showed that systemic administration of recombinant human EPO (rhuEPO) protects the brain from hypoxia ischemia brain injury. It seems that rhuEPO can cross a dysfunctional blood-brain barrier (BBB). However, it is unknown if systemic administration rhuEPO could cross premature BBB and promote premature brain development. In this study, we evaluated the effect of rhuEPO on the hematopoietic and neurobehavoirfor preterm infants. Methods1.Thirty-six premature newborn infants born in Jan. 2003 to Aug.2003 , fromNeonatal Intensive Care Unit(NICU) of our hospital, were enrolled this study according to the following criteria: gestational age was 28-35weeks;birth weight <2500 gram; there was no anemia , erythrpcytosis-, other haematological diseases > severe infection and congenital malformations.. Thirty-six infants were randomized to EPO treatment group and control group according tp the sequence of hospitalization. Twenty were in treatment group, sixteen were in control group. There was no significant difference in gestation age, birth weighty Apgar score of five minutes andthe ratio of the male and female between two groups(P>0.05).2. Infants in treatment group received rhuEPO at a dose 750 lU/kg body weight per week, three times a week every other day. The first time was administrated subcutaneously; others were given by venous for four weeks. All infants in two groups were given oral vit E (10mg/kg/d) from the second week of life; Elemental0 iron was supplied at a dose of 3mg/kg/d to both groups from the third week and increased 2mg/kg/d every week to maximal 7mg/kg/d.3. Hemoglobin (Hb), Hematocrit (Hct) , Red Blood Cell(RBC), reticulocyte counts (Ret), total leucocyte (WBC), Neutrophil counts(ANC), Platelet count (Plat) were measured before and every week after the treatment. Blood pressure was monitored every week. The average arterial pressure (MAP) was calculated according to the formula: MAP= (systolic pressure + 2 x diastolic pressure)/3. The liver and renal function parameters (SGPT, TBIL, BIH^ Cr) were measured before and after the treatment.4. Blood and cerebral spinal fluid (CSF) samples were taken before and after 2 weeks treatment in all the infants of two groups. The concentration of EPO was assayed by Enzyme linked immunosorbent assay (ELISA).5. Clinical follow up: Neonatal Behavioral and Neurological Assessment (NBNA) were taken at corrected gestation age of 40 weeks. Mental Development Index (MDI) and Psycho-motor Development Index (PDI) were evaluated at 3 and 6 month age by the CDCC methods.6. Statistics: All the data were expressed as mean SD. T test or no parameter test was used for comparing variance between two groups. All the data werecalculated by SPSS statistical software. Resultsl.Hb, Hct, RBC, Ret:HK Hct, RBC, Ret in both groups all declined afterbirth, but the degree of decrease in treatment group is significant lower. There is a significant difference between the two groups (P<0.01).The Ret in control group decreased after birth, but the Ret in treatment group increased in the first week. There was significant difference compared with that of control group (P<0.05). The count ofRet in treatment group reach peak at the third week and decreased after that, but still significantly higher compared with that of control in forth week after the treatment wasdone(P<0.01).2. The observation of adverse effect: There was no rhuEPO related clinical adverse effect was found. The value of WBC, ANC\ PLAI\ MAP, SGPT, TBIL> BUN, Cr was in normal range in the time of the study in two groups. There was no significant difference between the two groups (P>0.05).3. EPO concentratio...
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