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題名 | The Effect of Recombinant Human Erythropoietin in Treating the Anemia of Prematurity=合成人類紅血球生成素rHuEPO施用於早產兒貧血的效果 |
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作者 | 王澤生; 李菁菁; 鄧漢鑫; 林嘉盛; 張鑑熹; 林守田; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 36:2 民84.03-04 |
頁次 | 頁121-127 |
分類號 | 417.5171 |
關鍵詞 | 早產兒貧血; 合成人類紅血球生成素; Anemia of prematurity; Recombinant human erythropoietin; |
語文 | 英文(English) |
中文摘要 | 早産兒貧血傅統上以輸血來治療,最近研究報告使用rHuEPO治療早産兒貧血。我們研究了十四個發生早産兒分血的病兒使用rHuEPO治療下血液學方面的變化。這些早産兒平均的體重和懷孕週數,分別是1533.71±61.669和31.36±0.49週。使用第一劑rHuEPO時,平均爲26.14±2.03天大,平均血紅素值爲9.40±0.47g/dL。血比容爲28.20±0.81%。rHuEPO的劑量是200unit/kg皮下注射,每隔一天施打一次,共十例。同時我們給予口服鐵劑,每天3mg/kg及口服維他命E 25IU/kg 。在進入研究以前,測量到紅血球生成素平均值爲7.66±1.10mU/mL,是相當低的。使用之後,統計結果發現,校正綱狀經血球指數由0.64±0.10%(第零天)上升到1.68±0.42%(第五天),1.96±0.41%(第十二天),1.77±0.43%第廿天),(P<0.05)。紅血球及血比容皆上升,但無統計學上的意義。我們在第十天對九個病兒做骨髓穿刺,結果顯示,中到高度的細胞密度大部份是紅血球母細胞(47.89±1.78%), M/E比值相當低(0.57±0.05),顆粒球系列,淋巴球及血小板母細胞無特殊變化。同時我們發現,血液中絕對中性球數目於第廿天時,自3751.50±601.30/uL(第零天),有意義的下降至2405.57±342.76/uL。血小板數目無特殊變化,臨床顴察無其他併發症。血中ferritin濃度即使在已經給予鐵劑的情形下仍自208.81±28.58ng/mL(第零天)降至7994±20.44ng/mL(第廿天)(P<0.05)。我們認爲rHuEPO是另一種治療早産兒貧血的方法,然而預防性給法,長期影響,及最適當的劑量(rHuEPO及鐵劑)仍需進一步的研究。 |
英文摘要 | Anemia of prematurity (AOF) has been conventionally treated with erythrocyte transfusions. Recent investigations have reported the use of recombinant human erythropoietin (rHuEPO) as an alternative for treating AOP. The potential of rHuEFO in increasing erythropoiesis implies its clinical usefulness. The effect of rHuEFO on reticulocyte count as well as other parameters of blood cells was examined in 14 premature babies with AOP. The average birth body weight and gestational age of these premature babies were 1533.71±61.66g (Mean±SEM) and 31.36±0.49 weeks respectively. They received the first dose of rHuEPO at age 26.14±2.03 days with a hemoglobin level by 9.40±0.27g/dL and hematocrit level of 28.20±0.81%. They were given rHuEPO 200 U/kg subcutaneously every other day for 10 doses, and iron 3 mg/kg and vitamin E 25lU/kg per os every day. Average erythropoietin level of the patients on entry into this study was low (7.66±1.10mu/mL). After treatment with rHuEPO for 20 days, the corrected reticulocyte count increased from 0.64±0.10% to 1.68±0.42% on Day 5 (P<0.05), 1.96±0.41% on Day 12 (P<0.05), 1.77±0.43% on Day 20 (P<0.05), and hematocrit increased from 28.2±0.81% to 29.58±1.02% (P<0.05) on Day 20. Bone marrow aspirates on Day 10 for 9 infants revealed moderate to high cellularity, mostly with erythroblasts (47.89±1.78%); the M/E ratio was low (0.57±0.05). The granulocyte series and megakaryocyte could be well visualised. Absolute neutrophil count had significantly decreased on Day 20 (3751.50±601.30/uL on Day 1 v.s. 2405.57±342.76/uL on Day 20, P<0.05); platelet count had no significant change. Clinical observation revealed that there was no notable complication. In spite of the supplement of iron, the serum ferritin level decreased from 208.81±28.58ng/mL to 79.94±20.44ng/mL (P<0.05). Thus it is suggested that rHuEPO may offer an alternative way to treat AOP. |
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