静脉注射丙种球蛋白预防早产儿感染的探讨

A study on intravenous immunoglobulin for preventing infections of premature infants

目的：为了探讨静脉注射丙种球蛋白（ＩＶＩＧ）预防早产儿感染的价值。方法：用单向免疫琼脂扩散法检测６２ 例早产儿（胎龄３２周～３６周）入院时及１０ ｄ后的血清ＩｇＧ、ＩｇＭ、ＩｇＡ。同时随机分为ＩＶＩＧ组、抗生素组及对照组，分别 予以ＩＶＩＧ每天按０．５ｇ／ｋｇ～１．０ ｇ／ｋｇ稀释成５０ ｍＬ在２ｈ～３ｈ滴完，连用２ｄ；选择青霉素、头孢氨噻肟钠、氧哌嗪青 霉素，使用其中１种～２种．连用３ｄ～５ｄ。结果；ＩｇＧ均值随胎龄增加而升高（ｒ＝０．９２，Ｐ＜０．０１），而ＩｇＭ、ＩｇＡ差异无 显著意义。且ＩＶＩＧ组治疗后均值明显上升（Ｐ＜０．０１），而抗生素组及对照组较入院时无明显变化（Ｐ＞０．０５）；院内感 染发生率为２０．９７％，其中抗生素组发生率为３５．００％，对照组为２７．７８％，ＩＶＩＧ组仅为４．１７ ％。结论：静脉注射丙种 球蛋白预防早产儿感染效果满意。

Objective: In order to study the value of intravenous immunogobulin(IVIG) in preventing infections of premature infants. Methods :The serum levels of IgG.IgM and IgA were determined in 62 prematures with single immuno-diffusion thechnique. Meanwhile all cases were divided into IVIG group,antibotic group and control group. Immunogobulin 0. 5-1. 0 g/(kg· d) was given by intravenous infusion within 2-3 hours for two days in IVIG group. All cases of antibiotic group were treated with antibiotics(penicillin,cefotaxime sodium or piperacillin) for 3-5 days. Results: The serum level of IgG increased with the increase of gestational age (GA) (r=0. 92.P<0. 01).but IgM and IgA showed no significant differences. After treatment ,the mean level of IgG rised obviously in IVIG group .while it has no changes of the antibiotic group and control group (P>0. 05). The rate of Nosocomial infections disease was 20. 97% (antibiotic group: 35. 00% ,control group: 27. 78% , IVIG group:4. 17 %). Conclusions: Intravenous im-munogobulin(IVIG) has satisfactory effectiveness for preventing infections of premature infants.