Girlando P, Zuppa A A, Romagnoli C, Tortorolo G
Division of Neonatology, Department of Paediatrics, Catholic University of the Sacred Heart, Rome, Italy.
Biol Neonate. 2000 Nov;78(4):277-80. doi: 10.1159/000014279.
The effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) administration at 10 microg/kg/day for 15-30 min over 3 consecutive days in 3 preterm neonates with allo-immune neonatal neutropenia (ANN) is reported. Patients 1 and 2 had antibodies against antigen NA2, while patient 3 had antibodies against NA1. All neonates developed a rapid increase in absolute neutrophil count which reached the normal range within 48 h (from 75-640/mm(3) to 2,520-4,700/mm(3)). However, 23-25 days later, all 3 neonates relapsed into a second phase of severe neutropenia (408-870/mm(3)). Antibodies against neutrophil antigens were still positive during this period. This second-phase neutropenia persisted for 20-30 days and resolved spontaneously. It may be possible that when rhG-CSF is administered within a short time after birth in neonates with ANN, its effect is exhausted before the concentration of circulating antibodies decreases, with the result that a second phase of neutropenia can be expected.
报道了3例患有同种免疫性新生儿中性粒细胞减少症（ANN）的早产儿连续3天每天以10微克/千克的剂量注射重组人粒细胞集落刺激因子（rhG-CSF），持续15 - 30分钟的效果。患者1和患者2具有针对抗原NA2的抗体，而患者3具有针对NA1的抗体。所有新生儿的绝对中性粒细胞计数迅速增加，在48小时内达到正常范围（从75 - 640/mm³增至2520 - 4700/mm³）。然而，23 - 25天后，所有3例新生儿复发进入严重中性粒细胞减少的第二阶段（408 - 870/mm³）。在此期间，针对中性粒细胞抗原的抗体仍为阳性。这种第二阶段的中性粒细胞减少持续了20 - 30天并自发缓解。对于患有ANN的新生儿，在出生后短时间内给予rhG-CSF时，其效果可能在循环抗体浓度降低之前就已耗尽，结果可能会出现中性粒细胞减少的第二阶段。
