Prophylactic administration of intravenous immunoglobulins in the early stage of ischemic stroke

摘要

The administration of intravenous immunoglobulins (IVIG) in patients with a high risk of infection is considered a possible prophylactic measure in prevention of septic complications. Patients affected by stroke are extremely prone to infections. To determine whether such a treatment might be useful in stroke patients we designed the double-blind, randomized, placebo-controlled study. Seventy-two patients affected by recent (in last five days) acute ischemic stroke (neurological deficit in the Mathew's scale between 30-80 points) were included in the study groups. Patients underwent IVIG therapy (0.1-0.2 g/kg b.w. of Veinoglobuline - Institute Merieux-France on day 1, 3 and 7 of the study) or were given human albumin as a placebo (on the same days). The clinical outcome, septic complication, number of days of fever and use of antibiotics were recorded for 30 days or until patient's death. Three patients in the IVIG treated group and 9 patients in the control group died during the study. In the group receiving IVIG therapy there were no cases of death caused by septic complications. In 5 cases from the control group death was caused by infection. The neurological improvement assessed with the Mathew's scale was greater in the IVIG group compared to the placebo group. Immunological tests showed an enhancement of the immune response after stimulation by PHA and Con A in the group of patients treated with IVIG.