| ObjectivesTo observe the curative effect of erythropoietin(EPO)in the treatment of neonatal Hypoxi-ischemic Encephalopathy(HIE).To understand the influence of EPO on the prognosis of the patients.To investigate the effect of erythropoietin(EPO)on serum levels of NSE and SDF-1 in neonates with Hypoxi-ischemic Encephalopathy(HIE)and its clinical significance.MethodsAbout 81 cases of children with HIE were randomly divided into EPO treatment group(42 cases)and control group(39 cases).The EPO treatment group,included 13 cases of mild HIE,21 cases of moderate HIE,and 8 cases of severe HIE;The control group included 11 cases of mild HIE,22 cases of moderate HIE,and 6 cases of evere HIE;Forty-three healthy full-term neonates born during the same period were randomly selected as the normal control group.The control group and treatment group patients were given conventional treatment,Beside the conventional treatment,the EPO treatment group was intravenously injected with EPO of 200 IU/kg·d,3 times weekly,every 6 days blood routine examination time,according to the results of blood EPO dose was adjusted,treatment for 2 weeks.Blood samples of the three groups were collected on the first day after birth(before treatment)and the fifteenth day after birth(after treatment).Serum levels of NSE and S-100 B were measured by double-antibody sandwich ELISA.Observed two groups of children with neurological symptoms of recovery time,brain MRI changes.All the patients after 7d,14 d and 28 d for the neonatal behavior neurological determination(NBNA),3 months and 6 months after birth the infant intelligence development assessment(CDCC).And followed up 6 months and 12 months after birth.ResultsBefore treatment,the levels of NSE and SDF-1 in serum of HIE patients in the treatment group and control group were higher than that in normal newborns(P<0.01),whereas no significant differences in the levels of NSE and SDF-1 were observed between the conventional treatment and EPO treatment groups(P>0.05).The levels of NSE and SDF-1 on the fifteenth day after birth were significantly lower than those on the first day after birth in the three groups(P<0.01).After treatment,the serum NSE level in the treatment group was lower than that in the control group(P<0.05),and the level of SDF-1was higher than that of the control group(P<0.05).The improvement of brain imaging in3-6 months after birth,the EPO treatment group was better than the control group(P<0.05);The NBNA score in 7 days after birth,the proportion of normal subjects in the treatment group and the control group had no significant difference,which was lower than that of normal group(P<0.01);14 days and 28 days,the NBNA score of the treatment group was higher than the control group(P<0.05),but still lower than the normal group(P<0.01).The CDCC score in the treatment group was higher than that in the control group(P<0.05),but lower than that in normal group(P<0.01).Three months after birth,the CDCC score in the treatment group was higher than that in control group(P<0.05),but lower than that in normal group(P<0.01).Six months after birth,The proportion of normal subjects in the treatment group was significantly higher than that in the control group(P<0.05),but the difference was not statistically significant between the normal group and the normal group in MDI,but the normal proportion of PDI was still lower in normal group(P <0.05).Conclusions1.Dynamic detection of serum NSE and SDF-1 levels may contribute to the early diagnosis of HIE and to determine the severity of brain damage in children with HIE;2.EPO can increase the level of SDF-1,increase its high peak,and maintain a longer time;3.EPO may be involved in the repair of erve tissue through up regulation of SDF-1.4.EPO is beneficial to the early recovery of neurological symptoms in children with HIE,because the SDF-1 in children with HIE increase first and then decrease,the early use of EPO treatment may be more effective;5.EPO can significantly improve the long-term brain structure and the function in children with HIE. |
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