静脉丙种球蛋白治疗新生儿ABO溶血症对免疫功能影响的临床观察

Clincal observation of the effect of intravenous immunoglobulin on the immunity function of the newborn ABO-hemolysis

目的 通过新生几ABO溶血病使用静脉丙种球蛋白（IVIG）前后的免疫指标变化观察，观察IVIG使用对新生儿免疫功能的影响。方法 随机将新生儿ABO溶血症患儿分为两组，常规＋IVIG治疗为观察组，常规治疗为对照组，IVIG治疗剂量为800～1000mg／kg，分别测定使用IVIG前，使用IVIG后2d、28d、2个月体内IgG、IgM、IgA及T细胞亚群数值并与对照组对照。结果 观察组IgG、IgM在用药后2d、IgA在用药后28d与对照组比较有统计学意义，其余指标两组对照无统计学意义。CD3、CD8、CD4／CD8在治疗前后与对照组对照无统计学意义（P〉0．05）；CD4在用药前、用药后28d、2个月与对照组无统计学意义（P〉0．05），而在用药后2d与对照组相比有统计学意义（P〈0．05）。结论 IVIG治疗新生儿ABO溶血症剂量在800～1000mk/kg时，对新生儿的IgG、CD3、CD4、CD4／CD8数值不受影响，而在半衰期内可致IgM、IgA合成减少．CD4数值下降：提示有免疫抑制现象发生。

Objective To examine the effect of using intravenous immunoglobulin （IVIG） on the immunity function of the newhorn ABO-hernolysis.Methods All of the patients were divided randomly into two groups,A group （experimental group,which was given both regular therapy and IVIG） and B group （control group,which was given only regular therapy）. The dose of IVIG was 800-1 000 mg/kg. The values of serum IgG, IgM,IgA and second duster in the cell of T cell were compared between two groups before using IVIG, and 2,12,28 days and 2 months after ruing IVIG.Results The serum IgG level in A group was dramatically higher than that of B group on the 2^nd day after using IVIG. The serum IgM level in A group was dramatically lower than that of B group on the 2^nd day after using IVIG. The serum IgA level in A group was dramatically lower than that of B group on the 28^th day after using IVIG. CD3, CDs and CD4/CD8 levels in A group were not significantly different with that of B group after using IVIG. CD4 level in A group was not significantly different with that of B group on the 28^th day and on the 2^nd month after using IVIG. But CD4 level in A group, was significantly different with that of B group on the 2^nd after using IVIG. Conclusion The dose of IVIG ranges 800-1 000 mg/kg. The using of IVIG on ABO-hemolytic disease newborn infants doesn＇t inhibit the stir-synthesis of IgG, CD3, CD8,CD4/CD8 by the newborm, the selfsynthesis of IgM, IgA and CD4 may be inhibit in short periond. It hints the immunity represses occurrence.