早期大量丙种球蛋白治疗新生儿ABO溶血的效果研究

目的 探讨早期大量丙种球蛋白（IVIG）治疗新生儿ABO溶血（ABO-HDN）的效果.方法 回顾性分析76例ABO-HDN新生儿的临床资料,根据IVIG治疗时间和剂量分为常规组、冲击组和早期冲击组.比较3组新生儿治疗期间总胆红素水平、胆红素高峰值和峰值时间,观察治疗期间并发症等.结果 ①早期冲击组治疗前总胆红素、胆红素高峰值均显著低于常规组和冲击组（P＜0.05）,冲击组胆红素高峰值低于常规组（P＜0.05）;早期冲击组和冲击组胆红素达峰值时间显著低于常规组（P＜0.05）.②早期冲击组并发症发生率显著低于另外两组（P＜0.05）,且冲击组低于常规组（P＜0.05）.结论 新生儿ABO-HDN早期IVIG冲击治疗可降低血总胆红素水平,缩短高胆红素血症时间,避免出现高胆红素脑病和贫血.

Clinical study of early high-dose intravenous immunoglobulin therapy for ABO hemolytic disease of newborn

Objective To investigate the clinical therapeutic effect of early high -dose intravenous immunoglobulin （IVIG） on ABO hemolytic disease of newborn （ABO-HDN）.Methods 76 cases of ABO-HDN of newborn were studied retrospectively. Based on different IVIG dose and treating time, these newborn were divided into routine group, pulse group and early pulse group. Therapeutic effects as total bilirubin, the peak level of bilirubin and the peak appearance time, complications during treatment were evaluated and compared in these groups.Results （j）The total bilirubin and peak level of bilirubin in early pulse group were significantly lower than that other two groups（P〈0.05）. The peak level of bilirubin in pulse group were lower than routine group （P〈0.05）.The peak appearance time in pulse group and early pulse group both earlier than routine group （P〈0.05）. （~）The rate of complicaiton in early pulse group was lower than the other two groups, while the rate in pulse group was also lower than routine group（P〈0.05）. Conclusion Early high- dose IVIG treatment before obvious symptoms ABO-HDN occur could decrease level of bilirubin, and shorten biliru- binemia lasting time, prevent the progression of hemolytic complication.