Carnielli V, Montini G, Da Riol R, Dall'Amico R, Cantarutti F
Department of Pediatrics, University of Padua, Italy.
J Pediatr. 1992 Jul;121(1):98-102. doi: 10.1016/s0022-3476(05)82552-1.
To determine whether prophylactic treatment with recombinant human erythropoietin (rHuEPO) and iron would reduce the need for blood transfusions, we randomly assigned 22 premature infants with gestational ages less than or equal to 32 weeks and birth weights less than or equal to 1.75 kg to receive rHuEPO, 400 IU/kg three times a week, plus iron, 20 mg/wk intravenously, from the second day of life (11 infants), or no rHuEPO and no iron (11 infants). The two groups had similar birth weights and clinical variables. The treated infants required fewer blood transfusions (0.8 +/- 1.5 vs 3.1 +/- 2.1; p = 0.01) and less volume of packed erythrocytes (14.2 +/- 25.9 vs 48.4 +/- 34.0 ml/kg; p = 0.02). The amounts of blood sampled were not different (19.5 +/- 21.1 vs 27.8 +/- 19.1 ml/kg; p = 0.35). Reticulocyte and hematocrit values were higher in the treated group (4.46% +/- 0.8% vs 1.49% +/- 1.1% (p = 0.0001) and 48.1% +/- 7.3% vs 43.8% +/- 4.7% (p = 0.004), respectively). No side effects of either rHuEPO or intravenously administered iron were noted. These data indicate that rHuEPO, in combination with iron supplementation, is effective in reducing the need for blood transfusions in the premature infant. More information is needed on dosage, timing, and iron and vitamin supplementation.
为了确定重组人促红细胞生成素（rHuEPO）和铁剂的预防性治疗是否会减少输血需求，我们将22例胎龄小于或等于32周、出生体重小于或等于1.75kg的早产儿随机分为两组，一组（11例）从出生第二天起接受rHuEPO，每周三次，每次400IU/kg，加铁剂，每周静脉注射20mg；另一组（11例）不接受rHuEPO和铁剂。两组的出生体重和临床变量相似。接受治疗的婴儿需要的输血次数较少（0.8±1.5次 vs 3.1±2.1次；p = 0.01），浓缩红细胞输注量也较少（14.2±25.9ml/kg vs 48.4±34.0ml/kg；p = 0.02）。采血总量无差异（19.5±21.1ml/kg vs 27.8±19.1ml/kg；p = 0.35）。治疗组的网织红细胞和血细胞比容值较高（分别为4.46%±0.8% vs 1.49%±1.1%（p = 0.0001）和48.1%±7.3% vs 43.8%±4.7%（p = 0.004））。未观察到rHuEPO或静脉注射铁剂的任何副作用。这些数据表明，rHuEPO联合铁剂补充可有效减少早产儿的输血需求。关于剂量、给药时间以及铁剂和维生素补充还需要更多信息。
