高剂量和低剂量丙种球蛋白治疗新生儿ABO溶血病的临床效果

Clinical effect of high-dose and low-dose intravenous immunoglobulin in the treatment of neonatal ABO hemolytic disease

目的探讨高剂量和低剂量丙种球蛋白(IVIG)治疗新生儿ABO溶血病的临床效果。方法选取我院2010年12月至2014年12月收治的120例ABO溶血病患儿,随机分为A、B、C三组,每组40例。所有患儿均给予常规治疗措施,A组患儿给予静脉滴注高剂量IVIG,B组患儿给予低剂量IVIG,观察三组患儿的血清总胆红素(TBIL)水平、换血指征的发生率及不良反应发生率。结果治疗后24、48、72 h,A组患儿的血清TBIL水平明显低于B、C组,B组的血清TBIL水平也明显低于C组(P<0.05)。A、B两组患儿换血指征的发生率为0.00%,低于C组的2.50%(P<0.05)。A组患儿并未出现不良反应情况,不良反应发生率为0.00%(0/40);B组患儿的不良反应发生率为7.50%(3/40);C组患儿的不良反应发生率为27.50%(11/40);三组不良反应发生率比较,差异具有统计学意义(P<0.05)。结论不同剂量的IVIG治疗新生儿ABO溶血病,患儿的不良反应发生率有较大差异,IVIG药物的使用剂量越大,不良反应率越低,治疗效果也越好。

Objective To investigate the clinical efficacy of high-dose and low-dose intravenous immunoglobulin （IVIG） in the treatment of neonatal ABO hemolytic disease. Methods A total of 120 patients with ABO hemolytic disease admitted in our hospital from December 2010 to December 2014 were enrolled. All the patients were randomly divided into group A, group B and group C, with 40 cases in each group. All the children were treated with routine treatment, on the basis of the routine treatment, the group A received high -dose IVIG, and the group B accepted low -dose IVIG. The serum total bilirubin （TBIL） level, indication for exchange transfusion and adverse reactions were compared among the three groups. Results After treatment for 24, 48, 72 h, the TBIL level in the group A were significantly lower than those in the group B and group C, and the TBIL level in the group B was lower than that in the group C （P〈0.05）. The indication for exchange transfusion in the group A and group B was 0.00%, which were lower than 2.50% in the group C （P〈0.05）. The adverse reaction rates were 0.00% （0/40） in the group A, 7.50% （3/40） in the group B, and 27.50% （11/40） in the group C; the difference in adverses reaction rate among the three groups were statistically significant （P〈0.05）. Conclusion After different doses of IVIG in the treatment of ABO hemolytic disease, the adverse reaction rate is different, the higher the dose of IVIG, the lower the adverse reaction rate and the better the therapeutic effect.