Chen J Y, Wu T S, Chanlai S P
Department of Pediatrics and Nuclear Medicine, Chung Shan Medical and Dental College Hospital, Taiwan, Republic of China.
Am J Perinatol. 1995 Sep;12(5):314-8. doi: 10.1055/s-2007-994483.
Seventy premature infants (birthweight 1.75 kg or less, gestational age 33 weeks or less) with hemoglobin less than 10 g/dL and hematocrit less than 30% were studied and randomly divided into three groups. All of them received oral elemental iron 3 mg/kg/day and vitamin E 5 mg/kg/day during the study period. Recombinant human erythropoietin (rHuEPO) 150 U/kg was administered intravenously twice a week for 4 weeks in group A (26 infants). Infants in group A received a total of 4 erythrocyte transfusions because of frequent apnea. Infants in group B (25 infants) received erythrocyte transfusion when their hemoglobin levels was less than 10 g/dL with signs and symptoms (including tachycardia, tachypnea, poor feeding, apnea, poor weight gain) attributed to anemia or who had a hemoglobin less than 8 g/dL even if asymptomatic. Infants in group B received a total of 36 erythrocyte transfusions. Infants in group C (19 infants) were assigned to a non-rHuEPO and nontransfusion group. Three of the 19 premature infants in group C received erythrocyte transfusions later because of frequent and prolonged apneic episodes and were excluded from this study. Our data revealed that reticulocyte and serum erythropoietin values were higher (p < 0.01) in rHuEPO-treated group than transfusion group and hemoglobin and hematocrit values were lower in group C than the other two groups during the rHuEPO treatment period. No significant difference (p > 0.05) was found in neutrophil and platelet counts among these three groups. Serum ferritin values were found lower in the rHuEPO-treated group than the other two groups. Lower weight gain was found in infants in group C. We conclude that rHuEPO administration can reduce the need for blood transfusion. Poor weight gain can be found in infants with anemia of prematurity who do not receive rHuEPO or blood transfusion therapy.
对70例血红蛋白低于10g/dL且血细胞比容低于30%的早产儿（出生体重1.75kg或更低，胎龄33周或更低）进行了研究，并将其随机分为三组。在研究期间，所有患儿均接受口服元素铁3mg/kg/天和维生素E 5mg/kg/天。A组（26例患儿）静脉注射重组人促红细胞生成素（rHuEPO）150U/kg，每周两次，共4周。A组患儿因频繁呼吸暂停共接受了4次红细胞输血。B组（25例患儿）在血红蛋白水平低于10g/dL且出现归因于贫血的体征和症状（包括心动过速、呼吸急促、喂养困难、呼吸暂停、体重增加缓慢）时，或血红蛋白低于8g/dL即使无症状时，接受红细胞输血。B组患儿共接受了36次红细胞输血。C组（19例患儿）被分配到非rHuEPO和非输血组。C组19例早产儿中有3例后来因频繁和持续性呼吸暂停发作接受了红细胞输血，并被排除在本研究之外。我们的数据显示，在rHuEPO治疗期间，rHuEPO治疗组的网织红细胞和血清促红细胞生成素值高于输血组（p<0.01），C组的血红蛋白和血细胞比容值低于其他两组。三组之间的中性粒细胞和血小板计数无显著差异（p>0.05）。rHuEPO治疗组的血清铁蛋白值低于其他两组。C组患儿体重增加较慢。我们得出结论，给予rHuEPO可减少输血需求。未接受rHuEPO或输血治疗的早产儿贫血患儿体重增加较慢。
