부산대학교 도서관

Aim: To evaluate the effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) in preterm neonates with suspected sepsis and severe neutropenia (<1500 mm3), and to define the influence of maternal preeclampsia on rhG-CSF activity. Methods: Twenty neonates of normotensive mothers (NNMs) (GA 29.2±0.5 weeks and BW 1.024±81 g) and 20 born to preeclamptic mothers (NPMs) (GA 29±0.4 weeks and BW 946±55 g) were treated with rhG-CSF, 10 μg/kg per day for 3 days. Complete blood counts were obtained at day 0 (before rhG-CSF administration) and 1–4, 6, 9, 20 and 30 days later. Results: Absolute neutrophil count (ANC) increased rapidly (three-fold within 24 h), and significantly (maximum approximately 20–25 times starting values) and remained within normal range in both groups. However, in NNMs a two-phase increase occurred with an early peak on day 2 and a further peak on day 6 giving significantly higher ANC (P<0.001) than for NPMs at days 2–4 and 6. NPMs showed a gradual ANC increase with a single late peak occurring 3 days later than NNMs (day 9). The highest peak values for ANC were similar (15,900±1395 mm−3 for NNMs and 13,880±1097 mm−3 for NPMs). Neutropenia was completely resolved within 2 days in NNMs and within 4 days in NPMs. Conclusion: Preeclampsia seemed to influence the course of the ANC in spite of rhG-CSF administration, and a higher daily-dose for NPMs with neutropenic sepsis may more rapidly resolve neutropenia by overcoming the preeclampsia-associated inhibitor of rhG-CSF through a dose-dependent mechanism. [Copyright &y& Elsevier]