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[免疫球蛋白替代疗法治疗新生儿败血症]

[Immunoglobulin substitution in the treatment of neonatal septicemia].

作者信息

Sidiropoulos D, Böhme U, von Muralt G, Morell A, Barandun S

出版信息

Schweiz Med Wochenschr. 1981 Oct 31;111(44):1649-55.

PMID:7302548
Abstract

The therapeutic effect of a polyvalent immunoglobulin preparation for intravenous use was tested in 82 newborns with bacterial infections. 35 of the children had neonatal sepsis, whereas in the other 47 bacteremia was not detectable. Treatment consisted either of antibiotics only or of antibiotics combined wih immunoglobulin SRK on an alternating basis for the first six days. Immunoglobulin substitution was tolerated without complications. In the group of infants with neonatal sepsis, two of 20 (10%) who were substituted with immunoglobulin and four of 15 (26%) who received no immunoglobulin died. Likewise, in the group of patients without detectable bacteremia, two of 21 on immunoglobulin substitution (10%) and four of the 26 who were not substituted (15%) died. The low mortality observed in the present study was attributed to efforts at early diagnosis and conventional early treatment on the one hand, and to immunoglobulin substitution on the other. To detect possible late sequelae of immunoglobulin therapy, particularly in hypogammaglobulinemic premature newborns, clinical and immunological investigations were performed in the septic patient group at the age of one to four years. There were no indications that administration of immunoglobulins during the neonatal period might have had an adverse effect on psychomotor and somatic development or on the immunological maturation of the infants.

摘要

对82例患有细菌感染的新生儿进行了静脉注射用多价免疫球蛋白制剂的治疗效果测试。其中35名儿童患有新生儿败血症,而在另外47名儿童中未检测到菌血症。治疗方法为在前六天交替使用仅抗生素或抗生素联合免疫球蛋白SRK。免疫球蛋白替代治疗耐受性良好,无并发症。在患有新生儿败血症的婴儿组中,接受免疫球蛋白替代治疗的20名婴儿中有2名(10%)死亡,未接受免疫球蛋白治疗的15名婴儿中有4名(26%)死亡。同样,在未检测到菌血症的患者组中,接受免疫球蛋白替代治疗的21名患者中有2名(10%)死亡,未接受替代治疗的26名患者中有4名(15%)死亡。本研究中观察到的低死亡率一方面归因于早期诊断和传统早期治疗的努力,另一方面归因于免疫球蛋白替代治疗。为了检测免疫球蛋白治疗可能的晚期后遗症,特别是在低丙种球蛋白血症的早产儿中,对败血症患者组在1至4岁时进行了临床和免疫学调查。没有迹象表明新生儿期给予免疫球蛋白可能对婴儿的精神运动和身体发育或免疫成熟产生不利影响。

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