Phibbs R H, Shannon K M, Mentzer W C
Department of Pediatrics, University of California, San Francisco.
Acta Haematol. 1992;87 Suppl 1:28-33. doi: 10.1159/000204786.
There is a high level of erythropoiesis in the growing fetus. In utero relative hypoxia results in a relatively high haematocrit and predominant synthesis of haemoglobin F, with erythropoietin (EPO) produced in the liver regulating erythropoiesis. At birth after full-term pregnancy, fetal EPO concentrations are high, but decline progressively thereafter. In pre-term infants the expected postnatal decline in haemoglobin is more prolonged than in full-term infants and the premature infants may become anaemic. It has been shown in a randomized, double-blinded, placebo-controlled trial that recombinant human erythropoietin (r-HuEPO) at a dose of 100 U/kg given intravenously twice weekly for 6 weeks to infants with anaemia of prematurity produced an earlier increase in reticulocyte counts compared with placebo; however, the difference between treatments was not significant. r-HuEPO therapy did not suppress subsequent release of endogenous EPO. It is concluded that a higher dose of r-HuEPO may be required to treat anaemic premature infants.
正在成长的胎儿体内存在高水平的红细胞生成。子宫内相对缺氧导致相对较高的血细胞比容，并主要合成血红蛋白F，肝脏产生的促红细胞生成素（EPO）调节红细胞生成。足月妊娠出生时，胎儿EPO浓度较高，但此后会逐渐下降。与足月儿相比，早产儿出生后血红蛋白预期下降的时间更长，早产儿可能会出现贫血。一项随机、双盲、安慰剂对照试验表明，对于患有早产儿贫血的婴儿，每周两次静脉注射剂量为100 U/kg的重组人促红细胞生成素（r-HuEPO），持续6周，与安慰剂相比，网织红细胞计数更早升高；然而，治疗组之间的差异并不显著。r-HuEPO治疗并未抑制内源性EPO的后续释放。得出的结论是，可能需要更高剂量的r-HuEPO来治疗贫血早产儿。
