Capasso L, Borrelli Ac, Cerullo J, Pisanti R, Figliuolo C, Izzo F, Paccone M, Ferrara T, Lama S, Raimondi F
Division of Neonatology, Section of Pediatrics, Department of Translational Medical Science, University Federico II Naples, Italy, (
Transl Med UniSa. 2014 Dec 19;11:28-33. eCollection 2015 Jan-Apr.
Neonates, especially VLBW, are at high risk for sepsis related morbidity and mortality for immaturity of their immune system and invasive NICU practices. The paucity of immunoglobulins in preterm neonates consequently to the immaturity of immune system contributes to their high risk for systemic infection. The use of intravenous IgM enriched immunoglobulins, with higher antimicrobial activity than standard IgG, has been demonstrated in a retrospective study to reduce short term mortality in VLBW infant with proven sepsis. Larger, randomized prospective trials given the enormous burden of morbidity and mortality imposed by neonatal sepsis should urgently be addressed not only to validate this results but also to tailor the optimal scheme of treatment.
由于免疫系统不成熟以及新生儿重症监护病房（NICU）的侵入性操作，新生儿尤其是极低出生体重儿（VLBW）发生脓毒症相关发病和死亡的风险很高。早产儿免疫系统不成熟导致免疫球蛋白缺乏，这是其发生全身感染风险高的原因之一。一项回顾性研究表明，使用具有比标准IgG更高抗菌活性的静脉注射富含IgM的免疫球蛋白，可降低确诊脓毒症的VLBW婴儿的短期死亡率。鉴于新生儿脓毒症造成的巨大发病和死亡负担，迫切需要开展更大规模的随机前瞻性试验，不仅要验证这一结果，还要制定最佳治疗方案。
