南方医科大学学报

南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (09): 1350-.

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新生儿溶血病早期干预治疗的临床研究

黄为民； 陈红武； 李宁； 杨明； 焦培艳；   

  1. 南方医科大学南方医院新生儿科； 南方医科大学南方医院新生儿科 广东广州510515； 广东广州510515；
  • 出版日期:2006-09-20 发布日期:2006-09-20

Clinical study of early interventions for ABO hemolytic disease of the newborn

HUANG Wei-min, CHEN Hong-wu, LI Ning, YANG Ming, JIAO Pei-yan Department of Neonatology, Nangfang Hospital, Southern Medical University, Guangzhou 510515, China   

  1. 南方医科大学南方医院新生儿科； 南方医科大学南方医院新生儿科 广东广州510515； 广东广州510515；
  • Online:2006-09-20 Published:2006-09-20

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摘要： 目的探讨早期大剂量免疫球蛋白静脉滴注(IVIG)治疗新生儿ABO血型不合溶血病(ABO-HDN)的疗效。方法将121例确诊HDN患儿随机分成治疗组(61例)和常规组(60例)。治疗组在常规治疗基础上给予IVIG(400mg/kg·d,2￣3次),观察两组治疗效果。结果治疗组在治疗后第3天血清总胆红素值、日均血清总胆红素降低值分别为(153.42±45.21)μmol/L和(56.49±24.05)μmol/L,均低于常规组(P<0.01);治疗组黄疸消退时间(23.51±11.19)h,累计光疗时间(3.01±0.89)h,均短于常规组(P<0.01);治疗组治疗后的血红蛋白值均高于对照组(P<0.01)。结论早期大剂量IVIG能有效阻断溶血的继续发生,快速降低血清总胆红素,降低核黄疸的发生率,大大缩短光疗时间,是早期治疗新生儿ABO-HDN的有效手段。

Abstract: Objective To investigate therapuatic effect of high-dose intravenous immunoglobulin (IVIG) for early management of ABO hemolytic disease of the newborn (ABO-HDN). Methods A total of 121 cases with ABO-HDN were randomly divided into treatment group (n=61) and control group (n=60). In addition to the routine treatment of the control group, IVIG were given at a daily dose of 400 mg/kg to the cases in the treatment group for 2-3 times, and therapuatic effects were evaluated and compared between the two groups. Results The serum total billirubin concentration on the third day after treatment (153.42±45.21 μmol/L) and mean daily serum total billirubin concentration reduction (56.49±24.05 μmol/L) in treatment group were lower than those in the control group (P<0.01). The jaundice resolution time (23.51±11.19 h) and the phototherapy time (3.01±0.89 h) for billirubinemia treatment in treatment group were shorter than those in the control group (P<0.01). The patients in the the treatment group had higher hemoglobin level after treatment (15.59±2.01g/L) than those of the control group (P<0.01). Conclusion High-dose IVIG can effectively arrest the progression of hemolytic disease, quickly reduce serum total billirubin concentration and shorten phototherapy time for early treatment of ABO-HDN. 

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