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[孕周小于33周且体重低于1500克的早产新生儿低再生性贫血的诊断和治疗标准]

[Criteria for diagnosis and therapy of hyporegeneratory anemia in premature newborns below 33 week of gestation and body weight below 1500 grams].

作者信息

Pramatarova T, Vakrilova L, Slŭncheva B, Iarŭkova N, Kalaĭdzhieva M, Emilova Z, Shishkova R, Popivanova A, Zhekova N

出版信息

Akush Ginekol (Sofiia). 2007;46 Suppl 1:63-6.

Abstract

AIM

The aim of the present study is to define criteria for erythropoietin therapy of hyporegeneratory anemia in premature newborns according to hemoglobin (Hb) and hematocrit (Hct) concentration, and reticulocyte count (Ret).

MATERIALS AND METHODS

The prospective study includes two groups of 20 newborns with anemia of prematurity, body weight at birth below 1500 grams and gestation age below 33 gestation week. The newborns in the first group have been treated with beta-erythropoietin for four weeks--750-1000 E/kg weekly dose, divided q48h. Hb, Hct and Ret have been monitored and compared with that of control group newborns. The therapy of newborns in the control group consisted of blood transfusions.

RESULTS

The hematological parameters in the newborns from the first group have been increased permanently after the first week of therapy, with Ret being most sensitive to the therapy. In the second group of newborns, due to blood transfusions, transient increase of Hb and Hct, and decrease of Ret have been observed in next days after the blood transfusions.

CONCLUSIONS

The erythropoietin therapy of hyporegeneratory anemia in preterm newborns leads to rise in Hb, Hct and Ret. The therapy with blood transfusions suppresses erythropoiesis. This leads to decrease in Ret and transient rise in Hb, Hct and erythrocytes. That's why each blood transfusion leads to another one.

摘要

目的

本研究旨在根据血红蛋白(Hb)、血细胞比容(Hct)浓度及网织红细胞计数(Ret),确定早产儿低再生性贫血促红细胞生成素治疗的标准。

材料与方法

这项前瞻性研究包括两组各20例早产贫血新生儿,出生体重低于1500克,胎龄低于33孕周。第一组新生儿接受β-促红细胞生成素治疗4周,每周剂量750 - 1000 E/kg,每48小时分一次给药。监测Hb、Hct和Ret,并与对照组新生儿进行比较。对照组新生儿采用输血治疗。

结果

第一组新生儿治疗第一周后血液学参数持续升高,其中Ret对治疗最为敏感。第二组新生儿输血后,Hb和Hct出现短暂升高,输血后数天Ret下降。

结论

早产儿低再生性贫血的促红细胞生成素治疗可导致Hb、Hct和Ret升高。输血治疗会抑制红细胞生成,导致Ret下降,Hb、Hct和红细胞短暂升高。这就是为什么每次输血后都需要再次输血。

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