静脉输注IVIG辅助治疗新生儿ABO溶血病临床效果分析

Intravenous immunoglobulin for newborns with ABO-hemolytic disease

目的评价大剂量静脉输注丙种球蛋白（1VIG）辅助治疗新生儿ABO溶血病（ABO-HDN）的总胆红素及黄疸消退时长的变化。方法在常规治疗基础上治疗组予丙种球蛋白lg／kg，静脉输注，对比两组的总胆红素及黄疸消退时长。结果IVIG组和对照组患者入院时血清总胆红素分别为（306．79±71．63）μmol／L和（306．67±57．97）μmol／L，无显著性差异（t=0．007,P〉0．05）。IVIG组在治疗72小时后，体内血清总胆红素水平（148．81±29．15）μmol／L低于对照组（169．68±28．14）μmol／L，差异有统计学意义（t=2．773，P〈0．05）；IVIG组光疗时长（37±3．91h）较对照组（47±5．34h）明显缩短，差异有统计学意义（t=7．621,P〈0．05），IVIG组黄疸消退时长（96±22．34h）较对照组（141．52±39．2h）也明显缩短，差异有统计学意义（t=5．476，P〈0．05）。结论在常规治疗基础上，加用丙种球蛋白治疗ABO-HDN可有效降低血清总胆红素，缩短患儿的黄疸消退时间。

Objective To evaluate the clinical effect of IVIG on newborns with ABO-hemolytic disease. Methods Newborns with ABO- hemolytic disease were divided into two groups. Experimental group was given both regular therapy and IVIG （1 g/kg） ,while control group was given only regular therapy. The total serum bilirubin concentration and the days for jaundice resolution between two groups were compared. Results The total serum bilirubin of the experimental group and the control group before treatment was 306.79 ± 71.63mol/L and 306.67 ± 57.97mol/L respectively, and there was no significant difference （ t = 0. 007, P 〉 0.05 ）. When treated for 72h, the total serum bilirubin of the experimental group was 148.81± 29.15mol/L, which was lower than that of the control group （169.68 ±28.14） mol/L, and there was significant difference （ t = 2.773, P 〈 0.05 ）. The time of phototherapy of the experimental group （ 37± 3.91 h） was significantly shorter than that of the control group （47± 5.34h） （ t = 7. 621, P 〈 0. 05 ）. The days for jaundice resolution of the experimental group （96±22.34h） was significantly shorter than that of the control group （ 141.52± 39.2h）, and there was statistical significance （ t = 5. 476, P 〈 0.05）. Conclusion 1VIG is effective for newborns with ABO-hemolytic disease in reducing the level of total serum bilirubin and the days for jaundice resolution.