同种免疫性血小板减少症的产前治疗
Antenatal treatment of alloimmune thrombocytopenia.
作者信息
Lynch L, Bussel J B, McFarland J G, Chitkara U, Berkowitz R L
机构信息
Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Medical Center, New York, New York.
出版信息
Obstet Gynecol. 1992 Jul;80(1):67-71.
OBJECTIVE
Neonatal alloimmune thrombocytopenia is caused by platelet antigen incompatibility between the mother and fetus. Affected fetuses may have severe thrombocytopenia leading to intracranial hemorrhage before or at birth. We sought to treat this condition in utero to prevent these hemorrhages.
METHODS
Eighteen women who had previously delivered infants with severe alloimmune thrombocytopenia were treated with weekly infusions of intravenous gamma globulin from the diagnosis of fetal thrombocytopenia until birth; nine were also treated with corticosteroids.
RESULTS
There were no intracranial hemorrhages in the treated fetuses, compared with ten cases among the 21 untreated siblings (48%). Only three treated fetuses, compared with 16 of 20 untreated siblings, had platelet counts of less than 30,000/microL, with no bleeding complications.
CONCLUSION
Antenatal treatment of alloimmune thrombocytopenia with weekly gamma globulin effectively improves the fetal platelet count and prevents intracranial hemorrhage.
目的
新生儿同种免疫性血小板减少症是由母亲与胎儿之间的血小板抗原不相容引起的。受影响的胎儿可能会出现严重的血小板减少症，导致出生前或出生时颅内出血。我们试图在子宫内治疗这种疾病以预防这些出血。
方法
18名曾分娩出患有严重同种免疫性血小板减少症婴儿的女性，从诊断出胎儿血小板减少症到分娩，每周接受静脉注射丙种球蛋白治疗；其中9名还接受了皮质类固醇治疗。
结果
接受治疗的胎儿未发生颅内出血，相比之下，21名未接受治疗的同胞中有10例（48%）发生了颅内出血。只有3名接受治疗的胎儿血小板计数低于30,000/微升，而20名未接受治疗的同胞中有16名，且未出现出血并发症。
结论
每周使用丙种球蛋白对同种免疫性血小板减少症进行产前治疗可有效提高胎儿血小板计数并预防颅内出血。
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