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J Transl Med:红细胞生成素预防极早产儿坏死性小肠结肠炎

2021-07-30 MedSci原创 MedSci原创

坏死性小肠结肠炎(NEC)是极早产婴儿最严重的并发症之一,但目前还没有公认的方法来预防NEC。研究表明,红细胞生成素(EPO)有可能预防NEC或改善早产NEC的结果。近日,一项前瞻性的随机临床试验旨在

坏死性小肠结肠炎(NEC)是极早产婴儿最严重的并发症之一,但目前还没有公认的方法来预防NEC。研究表明,红细胞生成素(EPO)有可能预防NEC或改善早产NEC的结果。近日,一项前瞻性的随机临床试验旨在确定重组人EPO(rhEPO)是否可以预防早产儿NEC的发生,研究结果已发表于J Transl Med。

研究在四个NICU中心进行,共有1327名胎龄≤32周的早产儿被送入这些中心,排除42名婴儿,剩下1285名符合条件的婴儿随机分配到rhEPO或对照组。rhEPO组的婴儿每隔一天静脉注射500 IU/kg rhEPO,持续2周,而对照组则注射相同体积的盐水。主要结果是预防胎龄36周的极早产儿NEC的发生率。

 

结果显示,rhEPO治疗显著降低了NEC(I期、II期和III期)的发生率(12.0% vs. 17.1%,p = 0.010),特别是确认的NEC(II期和III期)(3.0% vs. 5.4%,p = 0.027)。同时,rhEPO治疗明显减少了确诊NEC病例的红细胞输注次数(1.2±0.4 vs. 2.7±1.0,p = 0.004)。亚组分析显示,rhEPO治疗显著降低了胎龄<28周的确诊NEC的发生率(p = 0.019),以及血红蛋白<90g/l(p = 0.000)和5分钟Apgar评分>5(p = 0.028)的早产儿各阶段NEC的发生率。

综上,该研究结果表明,反复小剂量rhEPO治疗对极早产儿的NEC有益。

 

原始出处:

 

Yong Wang, et al., Erythropoietin prevents necrotizing enterocolitis in very preterm infants: a randomized controlled trial. J Transl Med. 2020 Aug 8;18(1):308. doi: 10.1186/s12967-020-02459-w.

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    2022-02-01 bsmagic9140
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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419973, encodeId=4d5214199e3dc, content=<a href='/topic/show?id=c7d9e716941' target=_blank style='color:#2F92EE;'>#红细胞生成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77169, encryptionId=c7d9e716941, topicName=红细胞生成)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=489d3549369, createdName=许安, createdTime=Sun Aug 01 14:22:19 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457052, encodeId=c503145e052bf, content=<a href='/topic/show?id=09bd61685aa' target=_blank style='color:#2F92EE;'>#极早产儿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61685, encryptionId=09bd61685aa, topicName=极早产儿)], attachment=null, authenticateStatus=null, createdAvatar=null, 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  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1419973, encodeId=4d5214199e3dc, content=<a href='/topic/show?id=c7d9e716941' target=_blank style='color:#2F92EE;'>#红细胞生成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77169, encryptionId=c7d9e716941, topicName=红细胞生成)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=489d3549369, createdName=许安, createdTime=Sun Aug 01 14:22:19 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457052, encodeId=c503145e052bf, content=<a href='/topic/show?id=09bd61685aa' target=_blank style='color:#2F92EE;'>#极早产儿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61685, encryptionId=09bd61685aa, topicName=极早产儿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=521c5837609, createdName=wmr113, createdTime=Sun Aug 01 14:22:19 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1591631, encodeId=6dec159163140, content=<a href='/topic/show?id=253f4143849' target=_blank style='color:#2F92EE;'>#坏死性小肠结肠炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41438, encryptionId=253f4143849, topicName=坏死性小肠结肠炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=660517960040, createdName=doctor-chen9588, createdTime=Sun Aug 01 14:22:19 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1611185, encodeId=390a16111851e, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sun Aug 01 14:22:19 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004312, encodeId=027d10043123b, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sat Jul 31 23:35:33 CST 2021, time=2021-07-31, status=1, ipAttribution=)]
    2021-08-01 millore
  6. [GetPortalCommentsPageByObjectIdResponse(id=2067584, encodeId=c7d5206e5846e, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Sun Apr 17 12:22:19 CST 2022, time=2022-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1985401, encodeId=a49619854013c, content=<a href='/topic/show?id=6597e717313' target=_blank style='color:#2F92EE;'>#红细胞生成素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77173, encryptionId=6597e717313, 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  7. 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    2021-07-31 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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JAMA:对于极低出生体重儿,严重贫血增加了坏死性小肠结肠炎的风险

关于红细胞(RBC)输血和贫血而引起坏死性小肠结肠炎(NEC)的数据是相互矛盾的。这些关联还没有前瞻性评估,计算那些反复,随时间变化的风险。原始出处:Ravi M. Patel,Andrea Knezevic,Neeta Shenvi,et al.Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocol

2016新生儿坏死性小肠结肠炎小肠造瘘术后临床治疗专家共识发布

小肠造瘘术是新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)常见的手术方式之一,改善了危重NEC患儿的预后。但由于解剖生理的改变,术后易出现肠液大量丢失、营养物质消化吸收障碍,导致营养不良,水、电解质紊乱等临床问题,在治疗上极具挑战性。规范化的治疗可减少并发症的发生,改善预后,因此,就NEC小肠造瘘术后营养治疗、药物治疗、关瘘时机等问题经讨论形成如下专家共识。全

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