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三级学术医院新生儿早期 ABO 溶血病新生儿静脉注射免疫球蛋白 G 治疗:回顾性研究。

Intravenous immunoglobulin G in the treatment of ABO hemolytic disease of the newborn during the early neonatal period at a tertiary academic hospital: a retrospective study.

机构信息

Department of Neonatology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, Zhejiang, People's Republic of China.

出版信息

J Perinatol. 2021 Jun;41(6):1397-1402. doi: 10.1038/s41372-021-00963-5. Epub 2021 Feb 15.

DOI:10.1038/s41372-021-00963-5
PMID:33589732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8225508/
Abstract

OBJECTIVE

To evaluate the efficacy and safety of intravenous immunoglobulin G (IVIG) in infants with ABO hemolytic disease of the newborn (HDN).

METHODS

Infants with moderate-to-severe ABO HDN during early neonatal period (<7 days) at our hospital in 2017 were included in this retrospective study. Patients treated with IVIG and phototherapy were classified as the IVIG group, and those who only received phototherapy were classified as the phototherapy only group.

RESULTS

Forty-six patients were classified into the IVIG group and 68 other patients were classified into the phototherapy only group. There was no significant difference in duration of phototherapy, hospitalization periods, needs for exchange transfusion, transfusions, and incidence of bilirubin-induced neurological sequelae between these two groups (P = 0.20, 0.27, 0.65, 0.47, 0.78, respectively).

CONCLUSION

It seems unnecessary to expose neonates to IVIG in moderate-to-severe ABO HDN when the available data show no appreciable benefits.

摘要

目的

评估静脉注射免疫球蛋白(IVIG)治疗新生儿 ABO 溶血病(HDN)的疗效和安全性。

方法

本回顾性研究纳入了我院 2017 年早发性新生儿期(<7 天)中中重度 ABO-HDN 的婴儿。接受 IVIG 和光疗治疗的患者被分为 IVIG 组,仅接受光疗的患者被分为光疗组。

结果

46 例患者被分为 IVIG 组,68 例患者被分为光疗组。两组的光疗持续时间、住院时间、换血需求、输血需求和胆红素脑病发生率无显著差异(P 值分别为 0.20、0.27、0.65、0.47、0.78)。

结论

现有数据显示,中重度 ABO-HDN 新生儿应用 IVIG 并不能带来明显获益,似乎没有必要使用 IVIG。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f66/8225508/ba7ebdf0b4c5/41372_2021_963_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f66/8225508/72f2a9ea4b37/41372_2021_963_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f66/8225508/e34f171309d0/41372_2021_963_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f66/8225508/ba7ebdf0b4c5/41372_2021_963_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f66/8225508/72f2a9ea4b37/41372_2021_963_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f66/8225508/e34f171309d0/41372_2021_963_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f66/8225508/ba7ebdf0b4c5/41372_2021_963_Fig3_HTML.jpg

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本文引用的文献

1
Immunoglobulin for alloimmune hemolytic disease in neonates.新生儿同种免疫性溶血病用免疫球蛋白
Cochrane Database Syst Rev. 2018 Mar 18;3(3):CD003313. doi: 10.1002/14651858.CD003313.pub2.
2
Intravenous Immunoglobulins: Mode of Action and Indications in Autoimmune and Inflammatory Dermatoses.静脉注射免疫球蛋白:自身免疫性和炎性皮肤病中的作用模式及适应证
Int J Inflam. 2016;2016:3523057. doi: 10.1155/2016/3523057. Epub 2016 Jan 18.
Intravenous Immunoglobulin Use in Hemolytic Disease Due to ABO Incompatibility to Prevent Exchange Transfusion.
静脉注射免疫球蛋白用于ABO血型不合溶血病以预防换血治疗
Front Pediatr. 2022 Apr 28;10:864609. doi: 10.3389/fped.2022.864609. eCollection 2022.
4
Hemolytic Disease of the Newborn: A Review of Current Trends and Prospects.新生儿溶血病:当前趋势与前景综述
Pediatric Health Med Ther. 2021 Oct 7;12:491-498. doi: 10.2147/PHMT.S327032. eCollection 2021.