静脉丙种球蛋白在新生儿ABO溶血病中的疗效观察

摘要

Aim To explore the curative effect of intravenous immunoglobin( IVIG )used at different time on ABO hemolytic disease of the newborn. Methods 120 cases of neonatal ABO hemolytic in our hospital were divided into two groups, control group( n = 23 )and therapy group( n = 97 ). According to different time using IVIG,when therapy group was further divided into three sub groups, Ⅰ group not exceeding 24 hours after born, Ⅱ group between 24 hours and 48 hours, Ⅲ group over 48 hours( not exceeding 96 hours ). Common clinicai data( gestational age,sex,birth weight, blood type constituent ratio, et al ),the level of serum bilirubin and hemoglobin, and time of phototherapy and hospital days were analyzed. Results There were no significant differencesin gestational age, sex, birth weight, blood type constituent ratio and other common clinical data( P ＞ 0.05 ). But the changes of serum bilirubin and hemoglobin, phototherapy persistence time and hospital days had significant differences in two groups( P ＜ 0.01 ). Three cases had exchange transfusion therapy in the end in control group, but nobody in therapy group( P ＜ 0.01 ). There were significant differences in changes of serum bilirubin and hemoglobin,phototherapy persistence time and hospital days between Ⅰ group and Ⅱ group( P ＜ 0.01 ). Changes of serum bilirubin between Ⅱ group and Ⅲ group have differences( P ＜ 0.05 ), but there were no significant differences in the change of hemoglobin, phototherapy persistence time and hospital days. Conclusion IVIG can quickly reduce serum billirubin,phototherapy persistence time and hospital days,and at the same time control the degree of anaemia. And intravenous IVIG used within 24 hours after birth can have well curative effect.%目的 探讨大剂量丙种球蛋白(intravenous immunoglobulin,IVIG)在新生儿溶血病(ABO血型不合)中的疗效观察.方法 回顾性分析确诊新生儿ABO溶血病120例,A组(23例)为未给予IVIG治疗;B组(33例)在出生24 h内给予IVIG,C组(29例)在生后24～48 h内给予IVIG,D组(35例)在生后48 h后给予IVIG.IVIG剂量均为1 g·kg-1,其余治疗无差别.观察治疗前和治疗后24 h血中胆红素值、血红蛋白,以及各组的总的光疗时间和住院时间.结果 血红蛋白差值、血清胆红素的差值、住院时间及蓝光治疗时间:A组和B、C、D组相比均有显著差异(P＜0.01);B组和C、D组间也也有显著性差异(P＜0.01).C组和D组相比,血胆红素差值有统计学意义(P＜0.05);血红蛋白差值、光疗时间和住院天数差异无显著性(P＞0.05).A组中有3例需要换血治疗,B、C、D组中均无需换血者(P＜0.01).结论 大剂量丙球治疗新生儿溶血病能迅速减低血清胆红素值,纠正贫血,减少光疗时间和住院时间;且越早给予(生后24 h内),疗效越显著.