不同剂量丙种球蛋白对早产儿血清IgG影响及临床疗效观察

Effects of IVIG dosages on the serum IgG level of preterm neonates and its clinical observation

目的 探讨早产儿应用两种剂量静脉用丙种球蛋白 (IVIG)后血清IgG水平变化及临床疗效。 方法 将 6 0例早产儿按IVIG剂量随机分为三组 :A组 2 0 0mg/kg ,B组 40 0mg/kg ,C组不用IVIG为对照组。A、B组于生后 48h内分别应用 1次IVIG ,7d后分别取血测定其IgG水平 ,同时观察抗生素应用天数、病情稳定天数、住院天数、第 7d摄入奶的热量数及白细胞计数 ,三组进行比较。结果 用IVIG前 ,胎龄 <35周早产儿血清IgG水平低于胎龄≥ 35周者。A、B两组用药前后IgG水平差异有显著性 (t值分别为 3 99,5 71,P <0 0 5 )。对照组由于IgG消耗 ,第 7dIgG水平低于生后 48h内测定值 (t =5 73,P <0 0 5 ) ,A、B两组用IVIG后IgG水平均有提高 ,但两组间差异无显著性 (t=2 6 0 ,P >0 0 5 )。三组间F检验 (F =8 49,P <0 0 5 ) ,提示用IVIG可以提高IgG水平。A、B两组的抗生素应用天数、病情稳定天数、第 7d摄入奶的热量数与对照组相比存在统计学差异 ,但住院天数、白细胞计数均无统计学差异。结论 早产儿生后 48h内应用IVIG 2 0 0mg/kg或 40 0mg/kg均可提高血清IgG水平 ,用IVIG剂量 2 0 0mg/kg、40 0mg/kg与IgG增加水平无相关性。此外 ,用IVIG可缩短早产儿抗生素应用天数、病情稳定天数、提高第

Objective\ To study the changes of serum IgG level and clinical effect after using two dosages of IVIG in preterm neonates.Methods\ Sixty preterm neonates were randomly divided into 3 groups according to IVIG dosage:group A 200mg/kg,group B 400mg/kg,group C control cases.One dose IVIG was administered within 48 hours after birth,serum IgG of each case was measured before using IVIG and 7 days after,and then compared the three groups about the serum IgG level,the duration of antibiotics used,the days of patients condition stabilized,the duration of hospitalization,the calories of feeding and the leucocyte value on 7th day.Results\ The serum IgG level of preterm neonates whose gestational age below 35 weeks were lower than those above 35 weeks.Group A and group B showed a significant differences in the serum IgG level before and after IVIG used.(t values were:3 99 and 5 71,P<0 05).For group C,serum IgG level on 7th day was lower than that 48 hours after birth(t=5 73,P<0 05).After IVIG used,serum IgG of both group A and group B were increased,but had no remarkable differences(t=2 60,P>0 05).Inspection of F(F=8 49,P<0 05) demonstrated serum IgG level increased after using IVIG.There were statistical differences in the duration of antibiotics used,the days of patients condition stabilized and the calories of feeding on 7th day There were no differences in the duration of hospitalization and the leucocyte value on 7th day between group A and group B.Conclusion\ Application of IVIG 200mg/kg or 400mg/kg within two days after birth in preterm neonates can increase serum IgG level.There is no remarkable relationship between IVIG dosage and the increasing level of serum IgG.On the other hand,IVIG can shorten the duration of antibiotics used,the days of patients condition stabilized and increase the calories of feeding on 7th day.