极低出生体重儿高剂量与低剂量促红细胞生成素的比较。欧洲多中心重组人促红细胞生成素研究组。
High-versus low-dose erythropoietin in extremely low birth weight infants. The European Multicenter rhEPO Study Group.
作者信息
Maier R F, Obladen M, Kattner E, Natzschka J, Messer J, Regazzoni B M, Speer C P, Fellman V, Grauel E L, Groneck P, Wagner M, Moriette G, Salle B L, Verellen G, Scigalla P
机构信息
Department of Neonatology, Charité-Virchow-Klinikum, Humboldt-Universität Berlin, Germany.
出版信息
J Pediatr. 1998 May;132(5):866-70. doi: 10.1016/s0022-3476(98)70320-8.
OBJECTIVE
To investigate whether a weekly 1500 IU/kg dose of recombinant human erythropoietin (rhEPO) is more effective than a dose of 750 IU/kg/week in preventing anemia and reducing the transfusion need in infants with birth weights less than 1000 gm.
STUDY DESIGN
In a randomized, double-blind, multicenter trial, 184 infants with birth weights between 500 and 999 gm were treated with either rhEPO 750 (low-dose group) or 1500 IU/kg/week (high-dose group) from day 3 of life until 37 weeks' corrected age.
RESULTS
Thirty-two percent of the infants in each group did not receive any transfusion during the treatment period. The total volume of erythrocytes received was similar in each group. The success rate, defined as no transfusion needed and hematocrit value 0.30 L/L or greater, was 27.6% in the low-dose and 29.5% in the high-dose group (p = 0.96).
CONCLUSION
Doubling the rhEPO dose of 750 IU/kg/week is not indicated in infants with birth weights less than 1000 gm.
目的
探讨每周1500国际单位/千克剂量的重组人促红细胞生成素（rhEPO）在预防出生体重小于1000克的婴儿贫血及减少输血需求方面是否比750国际单位/千克/周的剂量更有效。
研究设计
在一项随机、双盲、多中心试验中，184名出生体重在500至999克之间的婴儿从出生第3天起至矫正年龄37周，分别接受750国际单位/千克的rhEPO（低剂量组）或1500国际单位/千克/周（高剂量组）治疗。
结果
每组中32%的婴儿在治疗期间未接受任何输血。每组接受的红细胞总体积相似。低剂量组和高剂量组中不需要输血且血细胞比容值达到或高于0.30升/升的成功率分别为27.6%和29.5%（p = 0.96）。
结论
出生体重小于1000克的婴儿，将rhEPO剂量从750国际单位/千克/周加倍并无必要。
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