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肠内给予红细胞生成素对早产儿喂养相关并发症的影响:一项初步的随机对照研究。

Effect of enteral erythropoietin on feeding-related complications in preterm newborns: A pilot randomized controlled study.

机构信息

Department of Paediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Department of Paediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

出版信息

Arab J Gastroenterol. 2020 Mar;21(1):37-42. doi: 10.1016/j.ajg.2020.01.001. Epub 2020 Mar 30.

Abstract

BACKGROUND AND STUDY AIMS

To evaluate the effects of enteral administration of recombinant human erythropoietin (rhEPO) on feeding-related complications in preterm infants.

PATIENTS AND METHODS

This double-blind, randomized controlled pilot study enrolled 120 preterm infants born ≤ 32 weeks' gestation who were admitted to the neonatal intensive care unit in a tertiary hospital; 60 patients randomly received recombinant human erythropoietin while the other 60 received placebo. Newborns who underwent cardiopulmonary resuscitation, infants with genetic syndromes, infants with inborn errors of metabolism, infants with major congenital or acquired gastrointestinal tract malformations, infants with previous use of parenteral growth factors such as recombinant human erythropoietin and granulocyte-macrophage colony-stimuating factor (GM-CSF) and infants previously treated with intravenous immunoglobulin were excluded. Overall, 48 patients withdrew from the study because of intravenous haematopoietic growth factor intake or death before treatment was completed. A total of 72 preterm infants remained in the study: 36 preterm infants in the erythropoietin (EPO) group, and 36 preterm infants in the placebo group. The day that enteral feeding was successfully started, the time to establishing one-half, two-thirds, and full enteral feedings (reaching at least 150 mL/kg/day), the number of episodes of feeding intolerance, the time to regain birth weight and the incidence of necrotizing enterocolitis (NEC) were recorded.

RESULTS

Both groups showed no significant difference in the time to achieve one-half, two-thirds, or full enteral feeding, no signs of feeding intolerance, and no cases of NEC were recorded.

CONCLUSION

Enteral erythropoietin does not appear to affect feeding intolerance or NEC incidence.

摘要

背景和研究目的

评估肠内给予重组人红细胞生成素(rhEPO)对早产儿喂养相关并发症的影响。

患者和方法

这是一项双盲、随机对照的初步研究,纳入了 120 名出生胎龄≤32 周的早产儿,这些早产儿均入住了一家三级医院的新生儿重症监护病房;60 名患儿随机接受重组人红细胞生成素治疗,而另外 60 名患儿接受安慰剂治疗。未纳入需要心肺复苏的新生儿、有遗传综合征的新生儿、有先天性或后天性胃肠道畸形的新生儿、有先天代谢缺陷的新生儿、有既往使用过重组人红细胞生成素和粒细胞-巨噬细胞集落刺激因子(GM-CSF)等肠外生长因子的新生儿、以及有既往静脉注射免疫球蛋白治疗史的新生儿。总体而言,由于治疗前接受静脉内造血生长因子摄入或死亡,有 48 名患儿退出了研究。共有 72 名早产儿仍留在研究中:36 名早产儿接受重组人红细胞生成素(EPO)治疗,36 名早产儿接受安慰剂治疗。在开始肠内喂养的那一天,记录达到半量、三分之二量和全量肠内喂养(达到至少 150 mL/kg/天)的时间、喂养不耐受发作次数、恢复出生体重的时间和坏死性小肠结肠炎(NEC)的发生率。

结果

两组患儿达到半量、三分之二量或全量肠内喂养的时间、无喂养不耐受迹象以及均未发生 NEC 等方面均无显著差异。

结论

肠内给予红细胞生成素似乎不会影响喂养不耐受或 NEC 的发生率。

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