Ovali F, Samanci N, Dağoğlu T
Department of Obstetrics and Gynecology, Istanbul University, Istanbul Medical Faculty, Turkey.
Pediatr Res. 1996 May;39(5):831-4. doi: 10.1203/00006450-199605000-00015.
The management of (Rhesus) hemolytic disease of the fetus and newborn includes intrauterine transfusions to prevent the development of hydrops, treatment of the possible hyperbilirubinemia in the immediate postnatal period, and treatment of late anemia. Low levels of serum erythropoietin due to suppression of the bone marrow by multiple intrauterine transfusions is a suggested mechanism for this anemia. The aim of our study was to test whether recombinant human erythropoietin reduced the need for erythrocyte transfusions in these infants. Twenty infants with Rhesus isoimmunization were blindly randomized to treatment and control groups at the 2nd wk of life. The number of intrauterine and exchange transfusions and demographic data were similar in both groups. The infants in the treatment group received recombinant human erythropoietin, s.c. 200 U/kg of body weight three times a week for a period of 6 wk, whereas the infants in the control group received a placebo for the same period. In the treatment group, the mean number of erythrocyte transfusions was significantly lower than that of the control group (1.8 versus 4.2). The reticulocyte counts and Hb levels rose earlier in the treatment group. The platelet and neutrophil counts were similar in both groups throughout the study. This study demonstrates that recombinant human erythropoietin treatment decreases the need for erythrocyte transfusions in the late anemia of infants with Rh isoimmunization. Considering the risks of blood transfusions, this decrease in the donor exposure is worthwhile.
胎儿及新生儿（恒河猴）溶血病的治疗包括进行宫内输血以预防水肿的发生、治疗出生后即刻可能出现的高胆红素血症以及治疗晚期贫血。多次宫内输血抑制骨髓导致血清促红细胞生成素水平降低是这种贫血的一种推测机制。我们研究的目的是检验重组人促红细胞生成素是否能减少这些婴儿的红细胞输血需求。20例恒河猴血型不合免疫的婴儿在出生后第2周被随机分为治疗组和对照组，分组过程采用盲法。两组的宫内输血和换血次数以及人口统计学数据相似。治疗组婴儿接受重组人促红细胞生成素，皮下注射，剂量为200 U/kg体重，每周3次，共6周，而对照组婴儿在同一时期接受安慰剂。治疗组的红细胞输血平均次数显著低于对照组（1.8次对4.2次）。治疗组的网织红细胞计数和血红蛋白水平升高得更早。在整个研究过程中，两组的血小板和中性粒细胞计数相似。本研究表明，重组人促红细胞生成素治疗可减少Rh血型不合免疫婴儿晚期贫血的红细胞输血需求。考虑到输血的风险，减少供血暴露是值得的。
