Baker C J
Baylor College of Medicine, Houston 77030.
J Clin Immunol. 1990 Nov;10(6 Suppl):47S-52S; discussion 52S-55S. doi: 10.1007/BF00918691.
Preterm infants are hypogammaglobulinemic at birth, a condition that worsens during the first several weeks of life. It has been postulated that periodic infusions of intravenous immune globulin in preterm infants might prevent systemic infections after age 7 days, but clinical trials have been inconclusive. To test this hypothesis in neonates weighing 500 to 1750 g at birth, a multicenter, randomized, double-blind, placebo-controlled trial was initiated. Either intravenous immune globulin (500 mg/kg) (284 infants) or placebo (5% albumin-normal saline, 10 ml/kg) (293 infants) was infused periodically for 8 weeks. Infusions were well tolerated. Mortality (4%) was similar in both groups. However, the incidence of systemic infection was significantly reduced in the treatment group, but only in those weighing less than 1500 g. More than 80% of infections were bacterial; half were caused by staphylococci. Standard use of intravenous immune globulin in preterm infants looks promising but must await full analysis of data from this and another ongoing multicenter trial.
早产儿出生时低丙种球蛋白血症，这种情况在出生后的最初几周会恶化。据推测，对早产儿定期输注静脉免疫球蛋白可能预防出生7天后的全身感染，但临床试验尚无定论。为了在出生时体重500至1750克的新生儿中验证这一假设，启动了一项多中心、随机、双盲、安慰剂对照试验。定期输注静脉免疫球蛋白（500毫克/千克）（284例婴儿）或安慰剂（5%白蛋白 - 生理盐水，10毫升/千克）（293例婴儿），持续8周。输注耐受性良好。两组死亡率（4%）相似。然而，治疗组全身感染的发生率显著降低，但仅在体重小于1500克的婴儿中。超过80%的感染为细菌感染；一半由葡萄球菌引起。早产儿常规使用静脉免疫球蛋白看起来很有前景，但必须等待对该试验以及另一项正在进行的多中心试验的数据进行全面分析。
