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探讨国产人血静脉丙种球蛋白(IVIG)辅助治疗新生儿破伤风的临床疗效及免疫功能。将40例新生儿破伤风患儿按病例编号分为常规组和IVIG组各20例。常规组采用破伤风抗毒素及安定类药物治疗;IVIG组在常规治疗组方案基础上加用IVIG(400mg/kg·d,静脉点滴,每日一次)共3天。并设20例健康新生儿作对照组。检测血清IgA、IgG、IgM和外周血T淋巴细胞亚群。比较实验前后的临床疗效和免疫功能变化。结果显示:①新生儿破伤风患儿血清IgG、CD_3、CD_4水平明显低于健康对照组;②静脉注射IVIG后,可迅速提高新生儿破伤风患儿血清IgG水平(5.86±0.62vs11.71±1.46)g/L,同时可提高CD_4细胞数(32.55±2.51vs44.23±4.87)和CD_4/CD_8比值(1.30±0.19 vs 2.10±0.11),P均<0.001;③IVIG组治愈率为85％,明显高于常规组55％,(x~2=4.28,P<0.05)。而平均治愈天数由(14.55±2.78)d缩短为(10.50±2.54)d(t=4.13,P<0.001)。病死率由20%降至10%。结论:免疫功能紊乱可能与新生儿破伤风有关。适宜的IVIG剂量辅助治疗新生儿破伤风,疗效肯定,副作用少,值得临床推广。
To investigate the clinical efficacy and immune function of domestic-made human blood vein gamma-globulin (IVIG) in adjuvant treatment of neonatal tetanus. 40 cases of neonatal tetanus in children by case number is divided into routine group and IVIG group of 20 cases. The conventional group was treated with tetanus antitoxin and diazepam. IVIG group was given IVIG (400mg / kg · d, once daily) for 3 days on the basis of routine treatment. And set 20 healthy newborn as a control group. Serum IgA, IgG, IgM and peripheral blood T lymphocyte subsets were detected. Before and after comparing the clinical efficacy and immune function changes. The results showed that: (1) Serum IgG, CD_3 and CD_4 levels in neonates with tetanus were significantly lower than those in healthy controls; (2) IVIG significantly increased serum IgG in neonates with tetanus (5.86 ± 0.62 vs11.71 ± 1.46) g / L, and the number of CD_4 cells (32.55 ± 2.51 vs44.23 ± 4.87) and CD_4 / CD_8 (1.30 ± 0.19 vs 2.10 ± 0.11) Significantly higher than the conventional group 55% (x ~ 2 = 4.28, P <0.05). The mean number of days cured was (14.55 ± 2.78) d to (10.50 ± 2.54) d (t = 4.13, P <0.001). The mortality rate dropped from 20% to 10%. Conclusion: Immune dysfunction may be related to neonatal tetanus. The appropriate dose of IVIG adjuvant treatment of neonatal tetanus, positive effect, fewer side effects, it is worth clinical promotion.