Study On The Correlation Between EPO And Brain Injury In Premature Infants

Objective 1.To study the intellectual development prognosis and related side effects of early high-dose and repeated low-dose recombinant human erythropoietin(r Hu-EPO)in the prevention and treatment of brain injury in premature infants;2.To study the correlation between serum EPO(Erythropoietin)concentration in the early stage of brain injury(12-24 hours after birth)and the incidence and severity of brain injury in premature infants;3.To explore the correlation between serum EPO(Erythropoietin)concentration and the incidence and severity of brain injury in premature infants;3.The value of clearing EPO concentration in early prediction of brain injury in premature infants.Methods Premature infants with gestational age less than 32W(gestational age based on last menstruation or gestational age assessment)who were admitted to our hospital within 24 hours from January 2018 to October 2018 were randomly divided into high dose group,repeated low dose group and control group.In addition to routine treatment,the high-dose group was given r Hu-EPO intravenous drip of 1000IU/kg,QD for 3 days,a total of 3000IU/kg.In addition to routine treatment,the repetitive low-dose group was given r Hu-EPO intravenous drip of 500IU/kg,once every other day,a total of 3000IU/kg.The control group was given routine treatment only.We regularly improved the head magnetic resonance and neonatal behavioral neurological assessment(NBNA)score and Gesell diagnostic development scale to evaluate the efficacy and intelligence development of premature infants;compared the changes of hemoglobin(Hg B),liver function(AST,ALT),renal function(Urea,Cr)before and after treatment,as well as hypertension,hemangioma,thrombosis,visual acuity of premature infants.The occurrence of omentopathy and other conditions,to evaluate adverse reactions.According to the severity of brain injury,the patients were divided into non-brain injury group,mild brain injury group and severe brain injury group.Serum EPO concentration was measured within 12 to 24 hours after birth,and the correlation between EPO concentration and brain injury was compared.Results 1.Compared with the control group,the NBNA score and Gesell scorewere significantly higher in the large dose group and the repetitive low dose group after 40 weeks,1 month and 3 months of gestational age correction,respectively(P < 0.05).There was no significant difference in intelligence development between the large dose group and the small dose group(P > 0.05).2.There was no significant difference in liver and kidney function between the three groups before and after treatment(P > 0.05).3.Hg B and the number of transfusions after treatment were lower in all three groups than before treatment,but the number of transfusions and the number of second transfusions in high-dose group and repetitive low-dose group were higher than those in control group(P < 0.05).There was no significant difference between high-dose group and low-dose group(P > 0.05).Compared with control group,the number of transfusions and the number of second transfusions in high-dose group and repetitive low-dose group were significantly higher.The difference was statistically significant(all P < 0.05),but there was no significant difference between high dose group and repetitive low dose group(all P > 0.05).4.After treatment,no hypertension,hemangioma,thrombosis and other diseases were found in the three groups.There were 8 cases of retinopathy in premature infants,including 3 cases in the repetitive low-dose group and 3 cases in the control group,2 cases in the high-dose group.There was no significant difference in the incidence among the three groups(P > 0.05).5.The relationship between serum EPO concentration and brain injury in preterm infants within 12-24 hours after birth was compared.The results showed that there was no significant difference between serum EPO concentration and the severity of brain injury in 12-24 hours after birth.The correlation analysis between serum EPO concentration and brain injury in preterm infants within 12-24 hours after birth indicated that there was a negative correlation between them.The correlation coefficient rs=-0.240,P=0.017,the difference was significant.The ROC curve analysis showed that the area under the curve was 0.690,the sensitivity was 62.2%,the specificity was 71.7%,and the Youden index was 0.339,suggesting that EPO concentration had certain predictive value for brain injury in premature infants.Conclusion 1.Short-term high-dose EPO and repeated low-dose EPO can treatpremature infants with brain injury,improve the neurodevelopmental prognosis of premature infants with brain injury,prevent and treat premature infants with anemia,reduce the number of blood transfusions,and no side effects or adverse reactions have been observed in this study.2.The lower the serum EPO concentration from 12 to 24 hours after birth,the greater the possibility of premature infant brain injury.However,there is no significant correlation between serum EPO concentration and the severity of premature infant brain injury.3.The serum EPO concentration at 12-24 hours after birth has certain predictive value for brain injury of premature infants.