静脉注射免疫球蛋白辅助治疗脓毒症相关性血小板减少症的疗效  

Adjuvant Therapy of Sepsis-associated Thrombocytopenia with Intravenous Immunoglobulin

作　　者：彭绵[1] 方伟强[2] 蔡举瑜[2] 吕丽燕[1] 

机构地区：[1]广东省深圳市第五人民医院ICU,518005 [2]汕头大学医学院第一附属医院ICU,515041

出　　处：《实用医学杂志》2015年第18期3072-3074,共3页The Journal of Practical Medicine

摘　　要：目的:探讨静脉注射免疫球蛋白对脓毒症相关性血小板减少症的辅助治疗效果。方法:采用前瞻性随机对照的研究方法,将入选的229例脓毒症且血小板计数<30×109/L的患者,分为干预组和对照组。对照组采用基础治疗;干预组在基础治疗的基础上加用免疫球蛋白静脉滴注0.4 g/(kg·d),每天1次,连用5 d。统计两组患者在应用免疫球蛋白静滴第1、3、5、7天的血小板计数以及两组患者的ICU留治时间和28 d住院病死率。结果:干预组的患者在应用免疫球蛋白第5天后开始,其血小板升高的幅度明显高于对照组(P<0.05)。与对照组相比,干预组的28 d住院病死率与存活患者的ICU留治时间均有明显改善(P<0.05)。结论:静脉注射免疫球蛋白对于严重脓毒症伴严重血小板减少症(血小板计数<30×109/L)的患者,其升高血小板的作用显著,并能明显缩短患者ICU留治时间,降低患者的病死率。Objective To investigate the adjuvant effect of intravenous immunoglobulin on patients with sepsis-associated thrombocytopenia. Methods A total of 229 patients with sepsis with platelet count less than 3× 109/ L, were included in this prospective, randomized, controlled study. The patients were divided into the intervening group and the control group. Conventional treatments were applied in the two both groups, while in the intervening group, intravenous immunoglobulin with a dose of 0.4 g /（kg·d） for 5 consecutive days was administered. The end-points were the platelet counts on day 1,day 3,day 5,and day 7 post-intravenous immunoglobulin, patients ＇ in-ICU time and the 28-day in-hospital mortality. Results Compared with the control group, the platelet count recovered dramatically after 5-day intravenous immunoglobulin in the intervening group.Moreover, the 28-day in-hospital mortality and in-ICU time were also dramatically improved in the intervening group. Conclusion Intravenous immunoglobulin can enhance the recovery of platelet counts, shorten the inICU time and reduce the hospital mortality in patients with sepsis- associated thrombocytopenia（PLT count 30× 109/ L）.

关 键 词：脓毒症相关性血小板减少症 静脉注射免疫球蛋白 

分 类 号：R459.7[医药卫生—急诊医学]