静脉注射丙种球蛋白治疗新生儿ABO溶血病的应用价值初探

Evaluate the applied value of intravenous immunoglobulin therapied hemolytic disease of the newborn due to A and B incompatibility

目的初步评估静脉注射大剂量丙种球蛋白治疗新生儿ABO溶血病的使用价值。方法回顾性分析2000年1月至2004年12月入我科的48例新生儿ABO溶血病资料。将病例分为单纯光疗组(对照组)与光疗+丙种球蛋白组(治疗组),分析两组间基本状况(年龄、性别等)及黄疸程度(血清总胆红素、间接胆红素),差异无显著性,具有可比性。同时分析两组光疗时机、黄疸消褪时间、住院时间、医疗总费用、检验费、药费的差异。结果1.光疗时机:对照组与治疗组分别为58.33±24.88小时、37.93±22.82小时,P>0.05,差异无显著性意义。2.褪黄效果:对照组与治疗组褪黄时间及住院时间分别4.0±1.49天、4.14±0.95天、6.3±1.89天、6.21±2.01天,P>0.1,差异无显著性。3.两组住院总费用、检验费、药费比较,P值均小于0.05,差异有显著性意义。结论1.光疗是治疗新生儿ABO溶血病简单有效的方法。2.静脉注射大剂量丙球可减轻溶血发生,但无清除胆红素作用,当黄疸明显时,并不缩短褪黄及住院时间,若使用对象、使用时机不当,只会增加医疗资源浪费及增加病人经济负担。

Objective To evaluate the applied value of intravenous immunoglobulin therapied hemolytic disease of the newborn due to A and B incompatibility. Methods 48 hemolytic disease of the newborn cases in our hospital from 2000 to 2004 was being object of observation. It was separated into simple light therapy （control group） and light therapy ＋ gammaglobulin （therapy group）, There was no significant difference of base situation （age, sex… ） and jaundiced level （serum total bilirubin, indirect bilinibin） between two groups. The difference of two group＇ s light therapied time, jaundice extinctive time, hospitalization time, total medical fee, test fee, pharmaceutical fee were also analysised. Results 1. Light therapied time： control group and therapy group separate were 58.33 ±24.88 hour, 37.93 ± 22.82 hour, P 〉 0.05, there was no significance of difference. 2. Jaundice extinctive effect： control group and therapy group＇ s jaundice extinctive time and hospitalization time separately were 4.0 ±1,49 days, 4.14 ±0.95 days; 6.3 ±1.89 days, 6.21 ± 2.01 days,P〉0.1, there were no significance of difference. 3, Two group＇s total medical fee, test fee and pharmaceutical fee were analysised, all of them are P 〈 0.05, there were significance of difference. Conclu- sion 1. It was simple and effective of that hemolytic disease of the newborn due to A and B incompatibility by light therapied. 2. Intravenous gammaglobulin may palliate hemolysis, but don＇ t extinctive jaundice or shorten hospitalization time. It also may increase wasting of medical resoure and patient＇ s economic burden if they were abused.