不同剂量的丙种球蛋白对新生儿ABO溶血病的治疗效果

目的探究不同剂量的丙种球蛋白对新生儿ABO溶血病的治疗效果。方法回顾性分析承德市兴隆县人民医院2012年1月—2013年7月收治的新生儿ABO溶血病患儿159例，随机平均分为3组，每组各53例。其中研究1组采用1g／kg大剂量丙种球蛋白进行治疗，研究2组采用0．5g／kg小剂量丙种球蛋白进行治疗，3组均进行常规治疗，包括蓝光照射、人工按摩等。测量患儿治疗1和3d后总胆红素含量，并记录黄疸消退的时间。同时采血观察3组患者红细胞计数和血红蛋白含量。结果入院治疗前，3组总胆红素含量差异无统计学意义（F=0．09，P=0．914〉0．05）。治疗1d后，对照组含量上升，研究1、2组大幅度下降，1组较于2组下降更加明显；治疗3d，研究1组总胆红素含量下降至（182±14）μmol／L，研究2组总胆红素含量下降至（213±16）μmol／L，对照组开始下降至（254±11）μmol／L，差异有统计学意义（F=68．29，P=0．000〈0．05）。3组患儿治疗1个月后，研究1组红细胞数量为（3．95±0．64）×10^12／L，研究2组红细胞数量为（3．74±0．42）×10^12／L，对照组红细胞数量为（3．49±0．52）×10^12／L，3组差异具有统计学意义（F=13．41，P=0．001〈0．05）。研究1组血红蛋白含量（122．82±7．90）g／L，研究2组血红蛋白含量（110．43±10．01）g／L，对照组血红蛋白含量（101．82±7．93）g／L，差异有统计学意义（F=143．32，P=0．000〈0．05）。结论丙种球蛋白对新生儿ABO溶血病的治疗效果显著，尤其以大剂量丙种球蛋白效果更佳，值得在临床上进行推广应用。

Observation on the therapeutic effect of gamma globulin with different doses on ABO hemolytic disease of the newborn

Objective] To observe the therapeutic effect of gamma globulin with different doses on ABO hemolytic disease of the newborn. Methods] A retrospective analysis was conducted to analyze 159 cases of ABO hemolytic disease of the newborn, which were treated in Xinglong People＇s Hospital of Chengde City from January 2012 to July 2013, and the patients were randomly divided into three groups, 53 cases in each group. The study group 1 was treated with large dose of gamma globulin （1 g/kg] , the study group 2 was treated with small dose of gamma globulin 0.5 g/kg） , and all three groups received the routine treatment, including the blue light irradiation and artificial massage. The total bilirubin content of children was measured at the first and third day of treatment, and time of recovery from jaundice was recorded. At the same time, the blood samples were collected from patients in three groups, to observe the erythrocyte count and hemoglobin content. Results ] Before treatment, there was no statistically significant difference in total bilirubin level among three groups （ F = 0.09, P = 0.914 〉 0.05 ）. After 1 day treatment, the total bilirubin level in the control group increased, while that in the study group 1 and 2 decreased significantly, and the decrease in the study group 1 was higher than that in the study group 2. After 3 day treatment, the total bilirubin level in the study group 1, the study group 2 and the control group was respectively （182 ±14） μmol/L, （213 ± 16） μmol/L and （254 ± 11 ） μmol/L, and the difference was statistically significant （ F = 68.29, P = 0.000 〈 0.05 ）. After 1 month treatment , the erythrocyte count in the study group 1, the study group 2 and the control group was respectively （ 3.95 ± 0. 64） × 10^12/L, （3. 74 ± 0. 42 ） × 10^12/L and （ 3.49 ± 0. 52 ） , 1012/L, and the difference was statistically significant （ F = 13.41, P = 0.001 〈 0.05 ）. The hemoglobin content in the study group 1, the study group 2 and the control group was respectively （ 122.82 ± 7.90 ） g/L, （ 110.43 ± 10.01 ） g/L and （ 101.82 ±7.93 ） g/L, and the difference was statistically significant （ F = 143.32, P = 0.000 〈 0.05 ）. Conclusion ] The therapeutic effect of gamma globulin on ABO hemolytic disease of the newbom is significant, and the large dose of gamma globulin has better effect, which is worthy of clinical application.