Yang Shu-Shuo, Xu Fa-Lin, Cheng Hui-Qing, Xu Hao-Ran, Yang Lin, Xing Jing-Yue, Cheng Lin
Department of Neonatology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2018 May;20(5):346-351. doi: 10.7499/j.issn.1008-8830.2018.05.002.
To evaluate the effect of early application of recombinant human erythropoietin (rhEPO) on white matter development in preterm infants using fractional anisotropy (FA) of magnetic resonance diffusion tensor imaging (DTI).
A total of 81 preterm infants with gestational age ≤32 weeks, birth weight <1 500 g, and hospitalization within 24 hours after birth were randomly divided into rhEPO group (42 infants) and control group (39 infants). The infants in the rhEPO group were administered rhEPO, while those in the control group were given the same volume of normal saline. The preterm infants of both groups took examinations of head magnetic resonance imaging, diffusion-weighted imaging, and DTI at the corrected gestational age of 35-37 weeks. FA was calculated for the regions of interest in both groups.
There was no significant difference in the incidence of intracranial hemorrhage, periventricular leukomalacia, focal cerebral white matter damage (CWMD), and extensive CWMD between rhEPO and control groups (P>0.05). Compared with the control group, the rhEPO group showed higher FA values at the posterior limb of the internal capsule, the splenium of the corpus callosum, frontal white matter, and occipital white matter (P<0.05). There was no significant difference in FA values at the parietal white matter, thalamus, lenticular nucleus, and caudate nucleus between the two groups (P>0.05).
Early application of rhEPO has a neuroprotective effect on white matter development in preterm infants.
采用磁共振扩散张量成像（DTI）的分数各向异性（FA）评估早期应用重组人促红细胞生成素（rhEPO）对早产儿白质发育的影响。
选取81例胎龄≤32周、出生体重<1500g且出生后24小时内入院的早产儿，随机分为rhEPO组（42例）和对照组（39例）。rhEPO组患儿给予rhEPO，对照组患儿给予等量生理盐水。两组早产儿均在矫正胎龄35 - 37周时进行头部磁共振成像、弥散加权成像及DTI检查。计算两组感兴趣区域的FA值。
rhEPO组与对照组在颅内出血、脑室周围白质软化、局灶性脑白质损伤（CWMD）及广泛性CWMD的发生率上无显著差异（P>0.05）。与对照组相比，rhEPO组在内囊后肢、胼胝体压部、额叶白质及枕叶白质处的FA值更高（P<0.05）。两组在顶叶白质、丘脑、豆状核及尾状核的FA值无显著差异（P>0.05）。
早期应用rhEPO对早产儿白质发育具有神经保护作用。
