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作者在24例严重Rh 致敏的孕妇中研究了静注丙种球蛋白(WIG)的治疗价值。IVIG 0.4/kg/日,连续用4—5天,根据丙种球蛋白的半寿期,每隔2周重复使用,直至分娩.24例患者分为三组:第一组8例,妊娠期<20周;第二组7例,妊娠期在20—28周内;第三组9例,妊娠期>28周。第一组中2例和第二组中1倒治疗前有胎儿水肿。24例中13例既往有胎儿或新生儿死亡的妊振史。结果:治疗前,第一组患者的中位抗-D 滴度(25.9±12.9IU/ml)显著高于另外两组,后者也高于10IU/ml。治疗前,第二、三两组患者的羊水中总胆红素浓度明显超过生理范围。第一、二两组中有3例在IVIG 治疗前存在胎儿水肿而后死亡,其余的胎儿在治疗期间未再发生胎儿水肿。第三组9例新生儿中6例出生时1分钟新生儿Apgar 积分<7,而5分钟时,新生儿Ap-gar 积分仅1例<7。所有新生儿出生时中位体重均超过2500克。脐血试验表明,各组新生儿血液学情况无显著差异。IVIG 治疗后,各组患者的抗-D 滴度
The authors studied the therapeutic value of intravenous gamma globulin (WIG) in 24 pregnant women with severe Rh-sensitization. IVIG 0.4 / kg / day for 4-5 consecutive days, according to the half-life of gamma globulin, repeated every two weeks until delivery .24 patients were divided into three groups: the first group of 8 patients, gestational age < 20 weeks; the second group of 7 cases, gestational within 20-28 weeks; the third group of 9 cases, pregnancy> 28 weeks. The first group of 2 patients and the second group of 1 down before treatment of fetal edema. Thirteen of the 24 patients had a previous history of pregnancy-induced fetal or neonatal death. Results: Before treatment, median anti-D titer (25.9 ± 12.9 IU / ml) in the first group was significantly higher than the other two groups, which was also higher than 10 IU / ml. Before treatment, the total bilirubin concentration in amniotic fluid of patients in the second and third groups obviously exceeded the physiological range. Three of the first and second groups had fetal edema before IVIG treatment and then died, while the remaining fetuses did not develop fetal edema during the treatment. Six of the nine newborns in the third group had an Apgar score of <7 at 1 minute of birth and only 7 of Apgar neonates at 5 minutes. All newborns at birth median body weight over 2500 grams. Umbilical cord blood tests showed that there was no significant difference in the hematology between neonates in each group. Anti-D titers in each group after IVIG treatment