产后早期应用促红细胞生成素及其与神经发育结果、脑室内出血和缺氧缺血性脑病发病率的关系:为期四周的观察研究

IF 1.4 Q3 PEDIATRICS
Oana Cristina Costescu, Aniko Maria Manea, Eugen Radu Boia, Daniela Mariana Cioboata, Florina Marinela Doandes, Ileana Enatescu, Sergiu Costescu, Mihaela Prodan, Marioara Boia
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引用次数: 0

摘要

本研究旨在探讨早期应用促红细胞生成素(EPO)对新生儿神经发育的影响,特别是对缺氧缺血性脑病(HIE)和脑室内出血(IVH)的影响。主要目的是确定早期服用 EPO 是否会影响短期神经发育结果,并为有神经发育障碍风险的新生儿提供安全性。这项观察性研究在罗马尼亚蒂米什瓦拉的 "路易斯-图尔卡努 "儿童急诊临床医院进行,包括121名接受EPO治疗的新生儿和130名未接受EPO治疗的对照组。EPO 在新生儿出生后 48 小时内给药,剂量为 1000 U/kg,必要时可增至 2000 U/kg。除了观察 IVH 和 HIE 的发生情况外,本研究还测量了临床和生化指标,包括 LDH、血糖、尿素、肌酐、CPK、CRP、PCT 和促红细胞生成素水平,以及血液学和凝血谱。两组的基线特征无明显差异。与无 EPO 组(38.0 秒)相比,EPO 组的 LDH 水平从第 1-3 天到第 7-10 天明显降低(从 695.0 U/L降至 442.0 U/L),APTT 值也明显降低(54.0 秒)。值得注意的是,早期给予 EPO 与 HIE 严重程度的显著降低有关(β系数:-0.38,p = 0.001)。此外,较低的胎龄和血红蛋白水平也与 HIE 严重程度的增加有关。到第四周时,与对照组相比,EPO 组的中度和重度 HIE 病例明显减少(p = 0.001)。新生儿早期服用 EPO 可明显降低 IVH 和 HIE 的严重程度,这表明 EPO 有可能成为新生儿护理中的一种神经保护剂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early Postnatal Administration of Erythropoietin and Its Association with Neurodevelopmental Outcomes and Incidence of Intraventricular Hemorrhage and Hypoxic-Ischemic Encephalopathy: A Four-Week Observational Study.

This study aimed to investigate the impact of early erythropoietin (EPO) administration on the neurodevelopment of newborns, specifically focusing on its effects on hypoxic-ischemic encephalopathy (HIE) and intraventricular hemorrhage (IVH). The primary objective was to determine whether early EPO administration could impact the short-term neurodevelopmental outcomes and provide safety in neonates at risk for neurodevelopmental disorders. Conducted at the "Louis Turcanu" Children's Emergency Clinical Hospital in Timisoara, Romania, this observational study included 121 neonates receiving EPO and 130 No EPO controls. EPO was administered within the first 48 h of life, with doses of 1000 U/kg that escalated to 2000 U/kg if necessary. Besides observing the occurrence of IVH and HIE, this study measured clinical and biochemical markers, including LDH, blood glucose, urea, creatinine, CPK, CRP, PCT, and erythropoietin levels alongside hematology and coagulation profiles. There were no significant differences in baseline characteristics between the groups. The EPO group showed significant reductions in LDH levels from days 1-3 to 7-10 (695.0 U/L to 442.0 U/L) and the APTT value (54.0 s) compared with the No EPO group (38.0 s). Notably, early EPO administration was associated with a significant decrease in HIE severity (beta coefficient: -0.38, p = 0.001). Additionally, lower gestational ages and hemoglobin levels correlated with increased severity of HIE. By week four, there was a significant reduction in moderate and severe HIE cases in the EPO group compared with controls (p = 0.001). Early administration of EPO in neonates significantly reduced the severity of IVH and HIE, suggesting its potential as a neuroprotective agent in neonatal care.

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来源期刊
Pediatric Reports
Pediatric Reports PEDIATRICS-
CiteScore
2.10
自引率
0.00%
发文量
55
审稿时长
11 weeks
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