静脉注射丙种球蛋白治疗早产儿重症感染的临床价值

目的探讨静脉注射丙种球蛋白(IVIG)治疗早产儿重症感染的临床价值。方法对30例重症感染的早产儿参考相似的孕周、体重、日龄及病情分成IVIG治疗组及对照组各15例,均选用同类抗生素且不用其他免疫制剂,IVIG组按每天0.5～1.0g.Kg-1稀释成50ml在2～3小时内静脉注射,连用3天。对所有30例早产儿均用单向免疫琼脂扩散法检测其血清IgG、IgA、IgM。结果⑴IgG均值随胎龄增加而升高(r=0.99,P<0.01),28～36周者<8.0g/L(28周仅4.5g/L),>36周者>8.0g/L;而IgA、IgM差异无显著意义。28～36周IgA均值为615mg/L,>36周者为621mg/L;28～36周者IgM均值为423mg/L,>36周者为418mg/L。⑵IVIG治疗1周后,IgG均值从8.2g/L升到13.5g/L(P<0.01);而对照组治疗1周后IgG均值仅6.7g/L。结论早产儿重症感染使用IVIG有满意疗效,而胎龄越小越有应用IVIG的指征。

Objective In order to study the clinic value of intravenous immunoglobulin(IVIG) intreating infections of premature infants.Methods Thirty premature neonates with serious infectionswere divided into IVIG group and control group. All cases were treated with similar antibioties withoutother immune preparataious.Immunoglobulin 0.5～1.0g.Kg-1.d-1 was given by intravenous infusionwithin 2～3 hours for one week.Therefore,the serum levels of IgG,IgA and IgM were determined in 30prenentunes with single immuno-diffusion technique. Results ⑴The serum level of IgG increated withthe increase of gestational age and the meam of IgG was positivsly correlated with gestational age(r=0.99,P<0.01). The mean level of IgG was <8.0g/L in 28～36 weeks of gestational age more than 36 weeks.But IgA and IgM show no significant differences. The mean level of IgA was 615mg/L in 28～36 weeks ofgestational age and 621mg/L in gestational age more than 36 weeks . The mean level of IgM was 423mg/L in 28～36 weeks of gestational age and 418mg/L in gestational age more than 36 weeks.⑵After a weekof treatment,the mean leval of IgG ineveased to 13.5g/L in IVIG group ,much ligher than 6.7g/L of thecontrol group(P<0.01).Conclusion IVIG has therapeutic effectiveness for treating serious infec-tions of premature infants.Therefore,the smaller the gestational age ,the more IVIG was indicated.