Chou Y H, Yau K I
Division of Neonatology, Chang Gung Children's Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1998 Dec;21(4):371-6.
Nosocomial infections are a major cause of death in premature infants, especially in very low birthweight (VLBW) infants. The VLBW infants have low serum immunoglobulin G levels, which may have an effect on infections in early infancy. Thus, prophylactic administration of intravenous immunoglobulin (IVIG) is proposed to maintain higher immunoglobulin G and reduce the rate of hospital-acquired infection.
A study for the effects of prophylactic IVIG therapy in VLBW infants was performed. A total of 61 VLBW infants were enrolled, and divided into the IVIG group (n = 31) and the control group (n = 30). The dose for each infant was 750-1000 mg/kg for those whose birthweight was less than 1000 g, and 500-750 mg/kg for infants whose birthweight was between 1001 and 1500 g. The control group received saline infusion. The infusions were given every 2 weeks until the infant weighed 1800 g, or was discharged.
The results showed: there were no major differences in the perinatal and neonatal characteristics between the two groups, consistently higher IgG levels were found in the IVIG group, and the age of first documented sepsis was earlier in the control group.
In this study, the prophylactic IVIG therapy may give substantially higher IgG levels, which may last for 2 months. However, a prophylactic effect for hospital-acquired infections was not observed.
医院感染是早产儿死亡的主要原因，尤其是极低出生体重（VLBW）婴儿。极低出生体重婴儿血清免疫球蛋白G水平较低，这可能会影响婴儿早期的感染情况。因此，有人提出预防性静脉注射免疫球蛋白（IVIG）以维持较高的免疫球蛋白G水平并降低医院获得性感染的发生率。
进行了一项关于预防性IVIG治疗对极低出生体重婴儿影响的研究。共纳入61例极低出生体重婴儿，分为IVIG组（n = 31）和对照组（n = 30）。出生体重小于1000 g的婴儿，每例的剂量为750 - 1000 mg/kg；出生体重在1001至1500 g之间的婴儿，剂量为500 - 750 mg/kg。对照组接受生理盐水输注。每2周输注一次，直至婴儿体重达到1800 g或出院。
结果显示：两组围产期和新生儿特征无显著差异，IVIG组的IgG水平始终较高，且对照组首次记录到败血症的年龄更早。
在本研究中，预防性IVIG治疗可能使IgG水平大幅升高，且可能持续2个月。然而，未观察到对医院获得性感染的预防作用。
