Objective To investigate into the effects of erythropoietin on serum NSE and S100B proteins in neonatal HIE.Methods A search was made of PubMed,EMbase,Web of Science,The Cochrane Library,CBM,CNKI,WanFang Data and VIP Database to collect randomized or quasi-randomized controlled trials of EPO intervention on NSE and S 100B proteins in neonatal HIE.Cochrane Collaboration's tool was used for assessing risk of bias to evaluate eligible studies' quality and Revman 5.2 software was used to conduct a metaanalysis.Results 13 studies including 761 infants were included.All studies were low in methodological quality.The meta-analysis showed:EPO compared with supportive therapy:the concentration of NSE and S 100B protein decreased markedly [MD=-3.62,95％ CI (-5.20,-2.04)] [MD=-0.12,95％ CI (-0.19,-0.06)],all of which were statistically significant.EPO combined with hypothermia therapy compared with single hypothermia therapy:NSE concentration MD=-8.22,95％ CI (-9.36,-7.09),P＜0.000 01;S100B protein concentration MD=-0.35,95％ CI (-0.43,-0.27),P＜0.000 01;the difference was statistically significant.In addition,EPO could significantly improve the NBNA score in HIE patients [MD=1.989 5％ CI (1.64,2.32),P＜0.000 01].Conclusion EPO can clearly reduce the level of brain damage markers (NSE and S100B proteins) and improve NBNA scores in the treatment of neonatal HIE,and exert a definite nerve protection.%目的 系统评价人促红细胞生成素(EPO)对新生儿缺氧缺血性脑病(HIE)患儿的血清神经元特异性烯醇化酶(NSE)和S100B蛋白含量的影响.方法 计算机检索PubMed、EMbase、Cochrane图书馆、Web of Science、中国生物医学文献数据库(CBM)、中国知网期刊全文数据库(CNKI)、万方数据库、维普数据库等,收集EPO干预对新生儿HIE的NSE、S100B蛋白影响的随机或半随机对照试验,利用Cochrane风险偏倚测量工具进行质量评价,利用Rev-man 5.2软件进行Meta分析.结果 共纳入13篇文献研究,包括761名新生儿.纳入研究方法学质量均较低.Meta分析示:EPO与常规治疗比较,NSE浓度和S100B蛋白浓度下降明显,差异均具有统计学意义.EPO联合亚低温疗法与单独亚低温疗法比较:NSE浓度MD=-8.22,95％CI(-9.36,-7.09),P＜0.00001;S100B蛋白浓度MD =-0.35,95％CI(-0.43,-0.27),P＜0.000 01,差异具有统计学意义.此外,EPO干预可明显提高患儿新生儿行为神经测定NBNA评分,MD=l.98,95％CI (1.64,2.32),P＜0.000 01.结论 EPO在治疗新生儿HIE方面,可明确降低脑损伤标志物NSE和S100B蛋白水平,并且改善患儿NBNA评分,有明确的神经保护作用.
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