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

张燕

（陕西省交通医院儿科，陕西 西安，710068）

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摘要：

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。

关键词：剂量；丙种球蛋白；ABO 溶血病

中图分类号：R722.18文献标志码：A文章编号：2096-1413(2017)28-0081-02

Clinical effect of high-dose and low-dose intravenous immunoglobulin in the treatment of neonatal ABO hemolytic disease
ZHANG Yan
(Department of Puediatrics, Shaanxi Traffic Hospital, Xi``an 710068, China)

ABSTRACT: 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.
KEYWORDS: dose; intravenous immunoglobulin; ABO hemolytic disease

参考文献：
[1] 袁洪斌,易平枝.不同剂量丙种球蛋白治疗新生儿ABO 溶血病临床疗效对比观察[J].临床和实验医学杂志,2015,14(10):802-805.
[2] 张文远,张桂平,孙志华.不同剂量的丙种球蛋白治疗新生儿ABO溶血症疗效观察[J].职业与健康,2013,29(6):765-766.
[3] 李英.不同剂量的丙种球蛋白对新生儿ABO 溶血病的疗效评价 [J].山西医药杂志,2016,45(4):383-385.
[4] 彭峰,孙智勇.大剂量一次性应用人血丙种球蛋白治疗新生儿ABO溶血病临床疗效观察[J].中国妇幼保健,2015,30(3):481-482.
[5] 高飞,苏莉.新生儿ABO 溶血病应用丙种球蛋白治疗最佳时机的临床研究[J].中国妇幼保健,2014,29(36):6042-6043.