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目的 观察两种剂量静脉注射免疫球蛋白(Intravenous immunoglobulin,IVIG)对新生儿肺炎患儿的疗效及其免疫抑制作用,为IVIG在新生儿肺炎的应用提供依据.方法 随机选取41例新生儿肺炎患儿,分为对照组,500~700mg/kg IVIG组及1000~1200mg/kg IVIG组,后两组分别于病程之l~4天接受IVIG治疗,其余治疗方法三组同.观察疗效并检测治疗前后患儿血清IgG、IgA、IgM、IgG亚类,T、B细胞增殖反应,外周血单个核细胞产生IgG亚类、IL-2、IL-4及IL-6能力.结果 两种剂量IVIG组患儿临床恢复情况与对照组相比无显著差异.与对照组比较,大剂量IVIG组治疗后血清IgG及IgG亚类水平明显升高,但其T、B细胞增殖反应、PBMC产生IL-2及IgG1、IgGZ2、IgG3水平明显下降.对照组治疗前后各指标均无明显变化.结论 IVIG对新生儿肺炎似无明显疗效,大剂量使用IVIG可能因其至少短期内具有抑制T、B细胞功能作用而加重新生儿期暂时免疫缺陷,故建议应据新生儿的免疫系统功能状态针对性选用IVIG.
Objective To observe the curative effect and immunosuppressive effect of two doses of intravenous immunoglobulin (IVIG) on neonates with pneumonia and to provide a basis for the application of IVIG in neonatal pneumonia.Methods 41 cases of neonatal pneumonia Children were divided into control group, 500 ~ 700mg / kg IVIG group and 1000 ~ 1200mg / kg IVIG group, the latter two groups were treated with IVIG for l ~ 4 days of course of disease, the rest of the three treatment methods were the same. IL-2, IL-4 and IL-6 in peripheral blood mononuclear cells were detected by ELISA.Results Serum IgG, IgA, IgM, IgG subclass, T, Compared with the control group, the serum IgG and IgG subclasses levels of the high-dose IVIG group were significantly increased after treatment, but the proliferation of T and B cells and the production of IL-2 And IgG1, IgGZ2, IgG3 levels were significantly decreased in the control group before and after treatment there was no significant change in each index.Conclusion IVIG no apparent effect on neonatal pneumonia, high-dose IVIG may be due to its at least short-term inhibition of T, B cell function And increase the neonatal period temporarily Immunodeficiency, it is recommended that the immune system should be based on the status of neonatal immune function targeted selection IVIG.