重组人类促红细胞生成素防治早产儿贫血的临床研究

目的探讨重组人类促红细胞生成素(rHu-Epo)防治早产儿贫血的疗效.方法将33例早产儿按入院次序分成治疗组17例,对照组16例.治疗组出生第1周即予rHu-Epo500IU*kg-1*w-1,隔日1次,每周3次皮下注射,共5周;对照组未予rHu-Epo治疗.两组早产儿生后第3周开始口服铁剂[元素铁5mg*kg-1*d-1],必要时输血,共观察7周.结果治疗组第2周开始网织红细胞较对照组明显升高(P＜0.01),第3周后渐下降但与对照组比较仍有显著差异(P＜0.05);两组患儿出生后Hb均渐下降,但治疗组程度较轻,最低Hb值较对照组高(P＜0.01),达最低Hb值的时间较对照组早(P＜0.01).治疗组血清铁蛋白第2周开始较对照组低(P＜0.01).治疗组输血率与对照组比较明显减少(P＜0.05).观察期末治疗组早产儿体重增长的速率较对照组高(P＜0.05).结论早期大剂量rHu-Epo能减轻早产儿贫血的程度,减少或避免输血;体内充足的铁储备是确保rHu-Epo疗效的重要因素.     

重组人类红细胞生成素预防早产儿贫血临床观察

目的　评价不同剂量的重组人类红细胞生成素 (rHuEPO)预防早产儿贫血的效果。方法　选择2 0 0 0～ 2 0 0 2年广州医学院荔湾医院收治的 6 7例胎龄≤ 34周 ,出生体重≤ 2 0kg早产儿 ,随机分为大剂量组、小剂量组和对照组。大、小剂量组分别于生后 3～ 7d接受rHuEPO每周 5 0 0IU/kg和每周 15 0IU/kg ,每周分 2次 ,皮下注射 ,共 6周 ;3组治疗期间均予 3～ 8mg·kg-1·d-1元素铁口服。分别于生后 1～ 8周、12周、16周观察各项血液学指标。结果　完成 16周研究的早产儿共 5 8例 ,3组生后血红蛋白、红细胞压积比均逐渐下降 ,大剂量组下降幅度最小 ,对照组下降最明显 (均P <0 0 1) ;大、小剂量组较对照组血红蛋白和红细胞压积比达最低值的时间提前。大、小剂量组网织红细胞于rHuEPO治疗 1周后即较对照组明显升高 ,尤以大剂量组上升幅度最明显 (P <0 0 1) ,治疗第 2～ 3周达高峰。 3组血清铁生后均呈下降趋势 ,但治疗期间治疗组下降较对照组明显 (P <0 0 1)。结论　rHuEPO辅以铁剂治疗可有效地预防早产儿贫血 ,且rHuEPO每周 5 0 0IU/kg优于每周 15 0IU/kg。     

不同剂量的重组人类促红细胞生成素在防治早产儿贫血中的应用

本研究应用不同剂量的重组人类促红细胞生成素(ｒｅｃｏｍｂｉｎａｎｔｈｕｍａｎｅｒｙｔｈｒｏｐｏｉｅｔｉｎ ,ｒｈＥｐｏ)防治早产儿贫血 ,以期探讨其在治疗早产儿贫血中的临床意义及最适剂量。对象及方法1 病例选择 :1996年 3月 1日～ 1999年 6月 30日 ,所有生后 2 4ｈ内入我院新生儿病房的早产儿 ,符合下列标准 :胎龄 <35周 ;出生体重≤ 180 0ｇ ;出生时无贫血、红细胞增多症、母子血型不合、感染及先天性疾患 ;病情相对稳定 ,血压正常。符合上述标准者共 75例。随机连续分为对照组和治疗 1组 [ｒｈＥｐｏ的剂量 75Ｕ (ｋｇ·周 ) ]、…     

国产重组人类促红细胞生成素防治早产儿贫血的临床效果研究

为评价国产重组人类促红细胞生成素（rhEPO）防治早产儿贫血的效果和安全性，将40例胎龄≤34周的早产儿随机分为治疗组及对照组各20例。治疗组予国产rhEPO750IU／（kg.w），每周分3次皮下注射，用药6周；对照组未用rhEPO；两组早产儿均口服铁剂。结果显示治疗组用药后血清促工细胞生成素水平显著高于对照组（P＜0．01）；治疗组血红蛋白、红细胞压积比、网积红细胞显著高于对照组（P＜0．01）；血清铁蛋白水平在用药后治疗组明显低于对照组（P＜0．01）；治疗组输血率较对照组明显减少（P＜0．01）；治疗组体重增长指标高于对照组9P＜0．05）。研究提示，国产rhEPO能有效防治早产儿贫血，且用药安全，无明显副作用。     

不同剂量促红细胞生成素防治早产儿贫血临床观察

目的评价不同剂量的重组人类促红细胞生成素(rHuEPO)防治早产儿贫血的效果,寻找最佳剂量。方法将152例胎龄<35周,体重<2.5 kg的早产儿随机分为大剂量组、中剂量组、小剂量组和对照组,分别于生后7 d接受rHuEPO治疗,剂量分别为每周750、450、150 U/kg,分3次给予皮下注射,共4周。各组均于第3周开始口服铁剂2~8/mg(kg.d)。观察各组早产儿血红蛋白(Hb),红细胞压积(HCT),网积红细胞,血清铁的动态变化。结果各组早产儿Hb、HCT均逐渐下降,但对照组下降明显大于其他各组,P<0.01,大剂量组下降幅度最小。对照组网积红细胞逐渐下降,各治疗组于第2周末逐渐上升,尤以大剂量组为明显,P<0.05。对照组有9例输血,小剂量组有4例输血,其他各组无输血,差异有显著性,P<0.01。各组血清铁生后均呈下降趋势,但治疗期间对照组下降较其他各组慢,P<0.05。结论rHuEPO能防治早产儿贫血,且大剂量较小剂量效果好。     

重组人类促红细胞生成素治疗极低出生体重早产儿贫血的近期疗效观察

目的:应用重组人类促红细胞生成素(rhu-EPO)治疗极低出生体重早产儿贫血并随访至出生后4个月,观察其疗效。方法：将56例极低出生体重早产儿按随机抽样原则分为对照组(26例)、治疗组(30例)。治疗组于生后第8天即予rhu-EPO,每次300 IU/kg,皮下注射,每周2次,共4周;第3周开始口服铁剂(每日5～10 mg/kg)。两组均于生后7 d内口服维生素E(每日5 mg/kg)、叶酸片(5 mg/d)。随访至出生后4个月。结果：随年龄增大两组血红蛋白、红细胞数、红细胞压积均逐渐下降,在7 d, 14 d, 21 d,28 d,35 d时,治疗组上述指标均较对照组高,差异有显著性意义(P<0.01或0.05);治疗结束后,两组的血清铁蛋白［(103±25 μmol/L vs (123±24) μmol/L)差异有显著性(P<0.01);治疗组较对照组出现贫血率低(43% vs 89%),两组比较差异有显著性(P<0.01)。结论：早期大剂量rhu-EPO能减轻早产儿贫血的程度,可减少甚至替代输血。     

重组人类促红细胞生成素预防极低出生体重儿贫血的研究

目的　评价重组人类促红细胞生成素 (rhu EPO)在相同剂量下不同应用频度对预防极低出生体重儿(VLBWI)贫血的效果。方法　将东南大学附属徐州医院儿科 2 0 0 1年 9月至 2 0 0 3年 9月收治的 2 2例VLBWI随机分成两组 ,均在出生第 8天开始予rhu EPO ,每周 75 0IU/kg ,共 6周。Ⅰ组 (12例 )每周 3次给药 ;Ⅱ组 (10例 )每周 1次给药。另设未予rhu EPO的 12例VLBWI作为对照组 (Ⅲ组 )。动态观察血红蛋白、红细胞计数、红细胞压积比等。结果　 (1) 3组患儿在出生第 2 8天血红蛋白值的差异均有统计学意义 (P <0 0 1) ,出生第 6 4天的差异有统计学意义 (P <0 0 1) ,但Ⅰ、Ⅱ组间 P =0 0 5 2。 (2 ) 3组患儿在出生第 2 8天红细胞计数的差异均有统计学意义(P <0 0 1) ,出生第 6 4天的差异有统计学意义 (P <0 0 1) ,但Ⅰ、Ⅱ组间P =0 0 74。 (3) 3组患儿在出生第 2 8天红细胞压积比的差异有统计学意义 (P <0 0 1) ,但Ⅰ、Ⅱ组间P =0 14 0 ,出生第 6 4天的差异有统计学意义 (P <0 0 1) ,但Ⅰ、Ⅱ组间P =0 195。结论　在rhu EPO相同的每周总量下 ,每周 3次给药比每周 1次给药能明显提高VLBWI的血红蛋白及红细胞计数     

重组人促红细胞生成素预治早产儿贫血的临床研究

为探讨重组人促红细胞生成素 (r HuEPO)防治早产儿贫血的疗效 ,将 5 2例早产儿按入院顺序随机分成治疗组 2 7例 ,对照组 2 5例。治疗组于生后 1周内给予rHu EPO 2 0 0IU/(kg·w) ,一周两次 ,皮下注射 ,共 6周 ;对照组未予rHu EPO。两组早产儿均给予口服铁剂 ,元素铁 3mg/(kg·d) ,每周增加 2mg/(kg·d) ,维生素E 2 5mg/d。必要时输血 ,共观察 7周。结果显示 :两组早产儿生后其血红蛋白值 (Hb)均逐渐下降 ,但程度不同。治疗组程度较轻 ,于第 6周时降至最低点 (118 0 4± 9 5 6g/L) ,第 7周时开始上升 ;治疗结束时二者差异显著 (P <0 0 0 1)。治疗组与第 2周开始网织红细胞计数 (Ret)较对照组明显升高 (P <0 0 0 1) ,于第 3周达到峰值 ,治疗结束时两组Ret无明显差异 (P >0 0 5 )。治疗组血清铁 (SI)第 2周时较对照组明显降低(P <0 0 0 1) ,第 4周时降至最低 (8 76± 1 84umol L) ,治疗结束时两组SI无明显差异(P >0 0 5 )。治疗组输血率 (7 4% )较对照组 (3 6% )明显减少 (P <0 0 5 )。两组早产儿治疗结束时体重无明显差异 (P >0 0 5 )。观察期间未发现明显副作用。结论 ,早期应用 (生后 1周以内 )rHu EPO能有效地减轻早产儿的贫血程度 ,并减少输血次数。     

早产儿贫血时血清促红细胞生成素的动态变化

目的：探讨促红细胞生成素（ＥＰＯ）与早产儿贫血的关系。方法：采用放射免疫法检测１６例早产儿血清ＥＰＯ、血红蛋白（Ｈｂ）、红细胞压积比（φＲＢＣ）、网织红细胞计数（Ｒｅｔ）、股静脉氧分压（ＰｖＯ２）的动态变化。结果：①早产儿ＥＰＯ水平生后逐渐下降，第３周末最低，以后缓慢上升，但至第５周末仍低于成年男性水平。②当早产儿Ｈｂ下降引起组织缺氧时，ＥＰＯ水平增高，但增高的幅度明显低于成年男性。③ＰｖＯ２＜３７ｋＰａ时，ＥＰＯ浓度均上升。④胎龄越小，ＥＰＯ水平越低。结论：ＥＰＯ水平低下是导致早产儿贫血的主要因素，为应用重组人类促红细胞生成素（ｒｈＥＰＯ）治疗早产儿贫血提供了理论依据。     

Successful treatment of neonatal rhesus hemolytic anemia with high doses of recombinant human erythropoietin

The authors report the use of high-dose recombinant erythropoietin (r-HuEPO) in a full-term newborn baby with severe postnatal rhesus hemolytic anemia (RHA). Hemoglobin (Hb) value and reticulocyte count at day 13 of life were 59 g/L and 234 x 10(9)/L, respectively. Three days after the r-HuEPO (870 U/kg/d) administration, reticulocyte count had increased more than 4-fold and Hb rose to 73 g/L. r-HuEPO was gradually decreased after 18 days of treatment. No major side effect was observed. In selected cases of severe anemia due to hemolytic disorders, transfusions may be avoided by the use of high doses of r-HuEPO.     

重组人促红细胞生成素对早产儿贫血和细胞免疫功能的影响

目的　观察重组人促红细胞生成素 (rHu Epo)对早产儿贫血的预防和细胞免疫功能的影响。 方法　将 6 0例早产儿随机分为治疗组和对照组各 30例 ,治疗组用rHu Epo 6 0 0IU/kg ,隔日一次× 6周 ,加常规治疗[速力菲 8mg/ (kg·d) ,VitC 0 .1Bid ;VitE 10mg ,qd],对照组仅用常规治疗。两组同时监测红细胞计数 (RBC)、血红蛋白 (Hb)、网织红细胞 (Ret) )、血清铁和细胞免疫功能的变化。结果　疗程结束后治疗组Ret 2 .0 7% ,对照组 0 .80 9% ,两组Ret相差 10个百分点左右。治疗组血清铁 13μmol/L ,对照组 2 2 .13μmol/L ,P<0 .0 1。治疗组贫血发生率 3.3% ,对照组 6 3.4% ,P <0 .0 1,两组贫血症状有明显差异。结论　rHu Epo能预防早产儿贫血     

Treatment of renal anemia with recombinant human erythropoietin

Anemia is an almost invariable feature of chronic renal failure and is particularly severe in children treated by long-term hemodialysis. Recombinant human erythropoietin (rhEPO) offers entirely new aspects in the treatment of renal anemia. This report presents three patients on maintenance hemodialysis aged 10, 10/10 12, and 18 years who were treated with rhEPO. Two suffered from hemochromatosis secondary to multiple transfusions. 100 U/kg rhEPO were administered three times weekly, and venesection after dialysis was performed when a target hematocrit value of 30% was achieved. Hematocrit, reticulocyte-counts and hemoglobin rose within 3 to 6 weeks after initiation of therapy in all patients. Serumferritin levels declined significantly in the two patients with hemochromatosis. No deterioration of the metabolic status (i.e. increase of blood urea nitrogen, serum-creatinine, -phosphate or -potassium) could be detected. Therapy had to be discontinued in one patient who experienced hypertensive ceisis. This patient, however, had suffered from severe hypertension prior to rhEPO therapy. Blood pressure remained stable in the other patients. We conclude that renal anemia can be effectively treated by rhEPO in children. Increase of blood pressure may necessitate discontinuation of therapy especially in primary hypertensive patients. Extensive studies are necessary to eluciate long-term effects of rhEPO in children.     

Comparison of 2 iron doses in infants receiving recombinant human erythropoietin therapy

OBJECTIVE: To compare iron sufficiency in premature infants receiving high-dose recombinant human erythropoietin (r-HuEPO), 1200 IU/kg per week, supplemented with 6 or 12 mg/kg per day of enteral iron. DESIGN: We conducted a prospective, double-blind, controlled study of premature infants receiving r-HuEPO therapy, randomly assigned to receive 2 different doses of iron. Measurements of ferritin, iron, total iron-binding capacity, reticulocyte count, hemoglobin level, and hematocrit were obtained at baseline, 4, and 6 weeks. Transferrin saturation was calculated; the number of blood transfusions and the incidences of sepsis were recorded. SETTING: This study was performed in the neonatal intensive care unit at Loma Linda University Children's Hospital, Loma Linda, Calif. SUBJECTS: Infants with a gestational age of 32 weeks or younger, older than 7 days, and receiving r-HuEPO therapy from March 1, 1997, to June 30, 1998, were eligible for the study. Infants were randomly assigned to receive 6 mg/kg per day or 12 mg/kg per day of enteral iron during a course of r-HuEPO therapy for 4 to 6 weeks. RESULTS: Sixty-four infants were enrolled in the study. Twelve infants did not complete the study; 52 completed 4 weeks and 41 completed 6 weeks of the study. While ferritin levels and transferrin saturation decreased in both groups over the study period, there were no differences between the 2 study groups. CONCLUSIONS: Infants receiving high-dose r-HuEPO therapy (1200 IU/kg per week) decrease their ferritin levels (measure of iron stores) even when receiving high enteral iron supplementation. Given that the ferritin levels were similar between the 2 groups, we speculate that the additional iron either was not absorbed or was not stored.     

The effect of recombinant human erythropoietin on the treatment of anemia of prematurity

OBJECTIVE: To assess the efficacy of erythropoietin in the prevention and treatment of anemia of prematurity, correlating the use of this drug with weight gain, length, and head circumference and comparing two administration schemes of he same weekly dose: daily use and twice a week. METHODS: The study comprised 42 premature newborns with gestational age up to 33 weeks, birthweight up to 1550 g, and postnatal age between 10 and 35 days. The newborns were randomized into three groups: patients in group 1 received seven daily doses of 100 U/kg erythropoietin per week; patients in group 2 received two 350 U/kg erythropoietin doses per week; and patients in group 3 did not receive the drug. Hematologic measurements, blood transfusion requirements, and growth rates were followed during therapy. RESULTS: Cases and controls did not differ with respect to weight, length, head circumference, and total time of hospital stay. At the end of the study, no significant difference was observed in the platelet count measurement means, white blood cell count, and ferritin levels in the three groups. However, the final hematocrit and hemoglobin values of patients who did not receive erythropoietin were significantly lower than those of patients who received the drug. The absolute reticulocyte count mean was significantly higher in patients who received erythropoietin after two weeks of treatment when compared with those patients who did not receive the drug. Patients in group 1 e 2 received fewer excessive transfusions (2 or more) than patients in group 3. The administration of 700 U/kg/week erythropoietin significantly reduced the number of excessive blood transfusions. There is no significant difference in blood transfusion volume between patients who received erythropoietin on a daily basis and those who received the drug twice weekly. CONCLUSIONS: the use of erythropoietin did not influence weight gain and growth. The administration of 700 U/kg/week erythropoietin in premature infants with gestational age up to 33 weeks and birthweight up to 1550 g stimulates erythropoiesis and significantly reduces excessive blood transfusion requirements. Erythropoietin showed to be a safe and well tolerated medication, with no short-term side effects in the study population.     

Recombinant human erythropoietin in anemia of prematurity

OBJECTIVE: To evaluate safety and efficacy of recombinant human erythropoietin (r-HuEPO)in reducing the need for red cell transfusions in anemia of prematurity. METHODS: forty -two preterm infants (gestational age <32 weeks) were randomly assigned to a "treatment" group (r-HuEPO 400 units/kg every alternate day * 10 doses) or "no treatment" (control) group. All infants on enteral feeds received oral iron 3 mg/kg/day, graded up to 6 mg/kg/day. RESULTS: Higher reticulocyte counts in week 2 and 3 and higher hemoglobin levels in week 4 were noted after treatment with r-HuEPO. Despite stumulated erythropoiesis, the frequency of transfusions could not be reduced with r-HuEPO therapy.Overall, Phlebotomy losses, frequency and volume of redcell transfusions were significantly more in neonates with birthweight <1000 grams compared with those with birthweight >1000 grams (p<0.05). Associated side effects of r-HuEPO such as neutropenia,sepsis, hypertension or increased risk of late death did not occur. CONCLUSION:r-HuEPO therapy was safe without any side effects.Inability of r-HuEPO therapy to minimize red cell transfusions for anemia of prematurity may be explained by a relatively strict red-cell transfusion policy and the desired degree of treatment effect.     

Subcutaneous recombinant human erythropoietin in children with renal anemia on continuous ambulatory peritoneal dialysis

Subcutaneous recombinant human erythropoietin (rHuEpo) treatment of renal anemia was performed in four boys and eight girls on CAPD, aged 0.8–12.5 (mean 7.4) years. In contrast to previous studies, our therapeutic goal was not set with a hematocrit of 30% but with full correction of anemia. Following a maximum weekly rHuEpo dosage of median 120 (range 100–240) IU/kg body weight, hcmatocrit increased in 10 children from 24 (14–29)%) within 12 (4–17) weeks to 40.1 (33.5–48.4)%. The weekly increase in hematocrit was 1.27 (0.5–3.1)%. The corrected reticulocyte count increased from I.3 (0.7–1.8)% to 2.3 (1.4–3.9)% within 4 (2–6) weeks. Eight childrcn fulfilled the protocol; six with an uncomplicated course were able to maintain a hematocrit of 37.1 (35.1–42.7)% with only one sc medication per week of approximately two-thirds of their highest weekly rHuEpo dosage. No serious adverse effect of rHuEpo therapy was observed.