丙种球蛋白不同剂量预防新生儿感染的疗效观察  

Effects of different doses of gamma globulin on prevention of neonatal infections

作　　者：王有峰[1] 孙文武[1] 赵瑞[1] 李洁冰[1] 蒋瑞奇 

机构地区：[1]南阳市第一人民医院儿二科,河南南阳473010

出　　处：《中华医院感染学杂志》2016年第14期3331-3333,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技计划973计划基金资助项目(20132013)

摘　　要：目的观察不同剂量的丙种球蛋白对新生儿预防感染的临床效果,为预防新生儿感染提供治疗方案。方法选取2014年1月-2015年6月在医院进行原发疾病治疗新生儿72例,将其随机分为A、B两组,每组36例;所有患儿在常规治疗护理的基础上,A组给予400mg/Kg丙种球蛋白(IVIG)静脉滴注,B组给予600mg/Kg IVIG静脉滴注,每周2次,3周后观察两组患儿的感染发生率、抗菌药物使用时间和住院时间,并比较两组患儿的治疗效果,两组患儿治疗前后血清抗体(IgG、IgM、IgA)水平变化以及并发症发生情况。结果 A组患儿发生感染10例,感染率为27.8%,B组患儿发生感染6例,感染率为16.7%,B组患儿感染发生率低于A组,但两组之间差异无统计学意义;治疗后,B组患儿的抗菌药物平均使用时间和平均住院时间均明显少于A组,差异有统计学意义(P<0.05);治疗后A组总有效率为91.7%,B组治疗总有效率为94.4%,两组差异无统计学意义;治疗后两组患儿血清IgG明显高于治疗前,差异有统计学意义(P<0.05),且B组患儿血清IgG明显高于A组,差异有统计学意义(P<0.05);治疗期间B组患儿并发症发生率为19.4,低于A组患儿30.5%,但两组之间无显著性差异。结论不同剂量的丙种球蛋白对新生儿进行预防性应用均可以明显提高血清IgG水平,但应用较高剂量的IVIG可以达到更加良好的效果,不仅可以提高患儿抗感染能力、减少并发症的发生率,而且可以显著减少抗菌药物使用时间和住院时间,值得临床上进一步研究应用。OBJECTIVE To observe the clinical effects of different doses of gamma globulin on prevention of neonatal infections so as to provide guidance for prevention of the neonatal infections.METHODS A total of 72 neonates with primary disease who were treated in the hospital from Jan 2014 to Jun 2015 were enrolled in the study and randomly divided into the group A and the group B,with 36 cases in each group.Based on the conventional treatment and nursing,the group A was given intravenous drip of 400mg/Kg of gamma globulin,the group B was given intravenous drip of 600mg/Kg of gamma globulin,twice a week.The incidence of infections,time of use of antibiotics,and length of hospital stay were observed and compared between the two groups of neonates after the treatment for 3weeks,the curative effects were compared,and the levels of serum antibodies（IgG,IgM,IgA）and incidence of complications were observed and compared between the two groups of neonates before and after the treatment.RESULTS The infections occurred in 10 neonates in the group A,with the infection rate 27.8%;the infections occurred in 6neonates in the group B,with the infection rate 16.7%;the infection rate of the group B was lower than that of the group A,however,there was no significant difference.After the treatment,the average time of use of antibiotics and average length of hospital stay were significantly shorter in the group B than in the group A（P〈0.05）.The total effective rate of treatment was 91.7%in the group A,94.4%in the group B,and there was no significant difference.The serum IgG level of the two groups of neonates was significantly higher after the treatment than before the treatment（P〈0.05）;the serum IgG level of the group B was significantly higher than that of the group A（P〈0.05）.The incidence of complications was 19.4%in the group B during the treatment,lower than 30.5% in the group A,however,there was no significant difference.CONCLUSION The prophylactic use of different doses of gamma globulin can remarkably raise the

关 键 词：丙种球蛋白 早产儿 感染 预防 

分 类 号：R722[医药卫生—儿科]