给新生儿静脉注射人免疫球蛋白：对B族链球菌血清抗体水平的变化

Intravenous administration of human IgG to newborn infants: changes in serum antibody levels to group B streptococci.

作者信息

Christensen K K, Christensen P, Bucher H U, Duc G, Kind C H, Mieth D, Müller B, Seger R A

出版信息

Eur J Pediatr. 1984 Dec;143(2):123-7. doi: 10.1007/BF00445799.

Abstract

A human IgG preparation was given intravenously to 36 newborn infants admitted to the neonatal intensive care unit because of suspected septicaemia. IgG was given as a single dose of 0.4 g/kg body weight. Patient serum was obtained immediately before and 30 min after terminating the infusion. Blood was also withdrawn 2 days after giving the IgG in eight of the infants. The sera were tested by radioimmunoassay for IgG antibody levels to surface antigens of group B streptococci (GBS) types Ia, Ib, II and III and to R-protein. The mean increases in anti-type Ia, Ib, II, III and R-protein antibodies 30 min after the end of infusion were 81%, 73%, 49%, 60% and 69% of the preinfusion levels, respectively. This was followed by a rapid decrease during the following 2 days to 25%-32% of the initial increases. Based on the above findings, a controlled trial of passive immunisation in the management of neonatal GBS septicaemia seems justified. The rapid decline in antibody levels would necessitate a second infusion 24 h after the initial immunoglobulin administration if the suspicion of septicaemia persists.

摘要

将一种人IgG制剂静脉注射给36名因疑似败血症而入住新生儿重症监护病房的新生儿。IgG的给药剂量为0.4 g/kg体重，单次给药。在输注结束前及结束后30分钟采集患者血清。在8名婴儿给予IgG后2天也采集血液。通过放射免疫测定法检测血清中针对B族链球菌（GBS）Ia、Ib、II和III型表面抗原以及R蛋白的IgG抗体水平。输注结束后30分钟，抗Ia、Ib、II、III型抗体和抗R蛋白抗体的平均增加量分别为输注前水平的81%、73%、49%、60%和69%。随后在接下来的2天内迅速下降至初始增加量的25%-32%。基于上述发现，在新生儿GBS败血症管理中进行被动免疫的对照试验似乎是合理的。如果败血症的怀疑仍然存在，抗体水平的快速下降将需要在首次给予免疫球蛋白后24小时进行第二次输注。