母婴血型不合新生儿溶血病早期干预治疗的临床研究

Clinical Study of the Early Interventions for Blood Type Incompatible Hemolytic Disease of the Newborn

目的探讨免疫净化联合中药早期干预治疗母婴血型不合新生儿溶血病(HDN)的疗效。方法自2006年6月～2009年5月来我院接受治疗的高效价孕妇共计65例,分成联合治疗组(34例)和中药治疗组(31例)。联合治疗组在常规中药治疗的基础上给予血浆去除及静脉输注丙种球蛋白(IVIG)治疗,观察两组治疗效果。结果联合治疗组在治疗后平均抗体效价降低、胎儿宫内发育情况、孕周及产后婴儿黄疸状况等指标均优于中药治疗组(P<0.01)。结论免疫净化联合中药早期干预治疗母婴血型不合新生儿溶血病,能有效降低母体内抗体水平,减轻胎儿溶血程度,提高胎儿的成活率,是早期预防新生儿溶血病的有效手段。

Objective To investigate therapuatic effect of early interventions by immunoelearance in combination with herbal medicine and high- dose intravenous immunoglobulin（IVIG） in treatment of hemolytic disease of the newborn（HDN）. Methods From June 2006 to May 2009 ,a total of 65 cases of pregnant woman were divided into combination treatment group （n=34）and control group（ n = 31）. In addition to the routine herbal medicine treatment of the control group, plasmaphoresis and IVIG were given to the cases in the combination treatment group. The therapeutic effects were evaluated and compared between the two groups. Results The mean serum antibody titers , the states of foetus intrauterine growth, gestation weeks and the jaundice degree of newborn were compared and analyzed.The results of treatment group were better than those of the control group（ P 〈 0.01 ）. There was significant difference between two groups. Conclusion In treatment of blood type incompatible HDN,immunoclearance in combination with herbal medicine has the advantage of faster efficacy and less side effects and is superior to herbal medicine. It can effectively arrest the progression of hemolytic disease, quickly reduce serum total antibody concentration and increase survival rate of the foetus. Immunoclearance in combination with herbal medicine for early management of HDN is an effective treatment method.