冯妍

[摘要]目的 探討促红细胞生成素（EPO）在新生儿缺氧缺血性脑病（HIE）中的应用效果。方法 选取2016年3月～2018年9月我院收治的80例HIE患儿，依据随机数字表法分为对照组和观察组，每组各40例。对照组给予常规治疗，在此基础上观察组给予EPO治疗。治疗后，比较两组患儿治疗效果、行为神经、智能发育及出生质量。结果 观察组总有效率95.00%（38/40）高于对照组的77.50%（31/40），差异有统计学意义（P=0.023）;出生后2、4周，观察组的新生儿行为神经测定（NBNA）评分高于对照组，差异有统计学意义（P<0.05）;出生3、6个月后时，观察组心理发展指数（PDI）与智能发育指数（MDI）评分高于对照组，差异均有统计学意义（P<0.05）;出生10个月后，观察组的精神运动能区、大运动能区、语言能区、社会适应能区及个人社交能区评分均高于对照组，差异有统计学意义（P<0.05）。结论 对HIE使用EPO治疗，有利于促进患儿恢复神经功能，改善智能发育，提升出生质量，值得临床推广。

[关键词]缺氧缺血性脑病;促红细胞生成素;神经功能;新生儿;出生质量

[中图分类号] R722.1          [文献标识码] A          [文章编号] 1674-4721（2020）7（c）-0116-03

Application effect of Erythropoietin on neonatal hypoxic-ischemic encephalopathy

FENG Yan

Department of Pediatrics， Anshan Women and Children′s Hospital， Liaoning Province， Anshan   114000， China

[Abstract] Objective To investigate the application effect of Erythropoietin （EPO） on neonatal hypoxic-ischemic encephalopathy （HIE）. Methods A total of 80 patients HIE with EPO treated in our hospital from March 2016 to September 2018 were selected and divided into control group and observation group by random number table method， 40 cases in each group. The control group was given conventional treatment， and the observation group was given EPO treatment on the basis of the control group. After treatment， the therapeutic effect， the newborn′s neurobehavioral development， intellectual development and birth quality between the two groups were compared. Results The total effective rate in the observation group was 95.00% （38/40）， higher than that of the control group， accounting for 77.50% （31/40）， and the difference was statistically significant （P=0.023）. The 2 and 4 week neonatal behavioral neurological assessment （NBNA） scores in the observation group were higher than those of the control group， and the differences were statistically significant （P<0.05）. At 3 and 6 months after birth， the psychological development index （PDI） score and mental development index （MDI） score of the observation group were higher than those of the control group， and the differences were statistically significant （P<0.05）. After the age of 10 months， the scores of psychomotor function area， gross motor function area， language function area， social adaption function area， and personal social contact function area in the observation group were higher than those of the control group， the differences were statistically significant （P<0.05）. Conclusion The use of EPO treatment for HIE is beneficial to promoting the recovery of neurological function， ameliorating intellectual development， and improving birth quality. It is worthy of clinical promotion.

[Key words] Hypoxic-ischemic encephalopathy; Erythropoietin; Neurological function; Newborn; Birth quality

新生儿缺氧缺血性脑病（HIE）是指围生期婴儿窒息造成脑部缺氧缺血性损害。该病主要因围生期窒息导致，还可由于胎盘异常、分娩过程异常导致，属于较严重的神经系统疾病，一旦发病对患儿神经系统发育造成障碍[1-2]。HIE不仅对新生儿生命安全造成危险，对病情严重患儿还可残留神经系统相关后遗症，如癫痫、智力落后、脑性瘫痪等，对患儿自身健康及家庭均造成严重消极影响。目前，临床对HIE治疗尚无满意措施，中枢神经修复类药物、鼠神经因子、脑蛋白水解物及鼠神经因子有一定疗效，但针对持久性脑损伤或病情程度较重患儿治疗效果及预后仍有待研究。促红细胞生成素（EPO）作为神经保护类药物，在近年来逐渐得到临床高度注视，EPO对神经细胞可起到营养作用，其与脑发育联系较大[3-5]。本研究使用常规治疗方式作为对照，对40例HIE患儿联合EPO治疗，取得良好效果，现报道如下。……