大剂量应用人血丙种球蛋白对新生儿ABO溶血病的临床疗效与安全性分析

Clinical efficacy and safety analysis of large doses of intravenous immunoglobulins in treating ABO hemolytic disease of the newborn

目的分析大剂量应用人血丙种球蛋白（intravenous immunoglobulins,IVIG）治疗新生儿ABO溶血病的临床疗效与安全性。方法选取我院2011年5月~2015年5月收治的32例ABO溶血病新生儿为研究对象,患儿均在蓝光照射治疗基础上加用IVIG,剂量为1 g/（kg·d）,持续3 d。比较治疗前后患儿血清总胆红素（total bilirubin,TBIL）、血红蛋白（haemoglobin,Hb）变化及黄疸消退时间,并观察其不良反应发生情况。结果患儿治疗3 d后血清TBIL均较治疗前显著下降,降至（120.71±33.58）μmol/L,与治疗前差异有统计学意义（P〈0.05）;治疗前后Hb未见明显变化（P〉0.05）。患儿黄疸消退时间、住院时间分别为（5.15±1.37）d、（4.38±1.17）d。患儿治疗期间均未见发热、拒奶、皮疹等不良反应,总有效率为96.9%。结论大剂量应用IVIG治疗新生儿ABO溶血病起效时间快、效果佳,且安全性良好,对患儿预后的改善具有积极意义,值得推广。

Objective To analyze the clinical efficacy and safety analysis of large doses of intravenous immunoglobulins（IVIG） in treating ABO hemolytic disease of the newborn. Methods A total of 32 cases of the newborn with ABO hemolytic disease in our hospital from May 2011 to May 2015 were chosen for the study, and the newborn received 1g/（kg·d） IVIG on the basis of blue light treatment for 3 days. Serum total bilirubin（TBIL） change, hemoglobin（Hb）change and jaundice eliminating time of the two groups of the newborn were compared, and the incidence of adverse reactions was observed. Results Compared with that before treatment, serum TBIL in children 3 days after treatment decreased significantly, and was（120.71±33.58） μmol/L, and the difference was statistically significant（P〈0.05）. There was no significant change in Hb before and after treatment（P〉0.05）. Jaundice eliminating time of children was（5.15±1.37） days, and hospitalization time was（4.38±1.17） days. During the treatment of children, there was no fever, refusal to milk, skin rashes and other adverse reactions, and the total effective rate was 96.9%. Conclusion Large dose of IVIG in the treatment of neonatal ABO hemolytic disease has faster onset time, better efficacy and better security, and positive significance in improving the prognosis of children. So, it is worth of promotion.