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目的探讨应用大剂量静脉推注免疫球蛋白(HIVIG)治疗新生儿缺氧缺血性脑病(HIE)的疗效和安全性。方法将确诊为HIE新生儿51例随机分为两组,常规治疗对照组(25例),HIVIG治疗组(26例),在常规综合治疗的基础上48 h内加用IVIG 800 mg/(kg.d)静脉滴注,连续3 d,比较两组HIE患儿治疗后的神经症状消失时间及病程中多脏器功能受损情况。结果HIVIG治疗组在惊厥停止、肌张力恢复、意识障碍、原始反射、呼吸节律恢复时间比对照组要缩短,差异有统计学意义。所有接受HIVIG治疗的新生儿无一例发生不良反应。结论HIVIG可通过抑制炎性细胞因子的产生,减轻脑细胞缺氧缺血后的免疫病理损伤,缩短HIE病程,缓解主要神经症状,并改善HIE的近期预后。
Objective To investigate the efficacy and safety of high dose intravenous immunoglobulin (HIVIG) in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE). Methods Fifty-one neonates diagnosed as HIE were randomly divided into two groups: conventional treatment control group (n = 25) and HIVIG treatment group (n = 26). On the basis of conventional comprehensive treatment, IVIG 800 mg / d) for 3 consecutive days. The disappearance time of neurological symptoms and the impaired multiple organ function during the course of disease were compared between the two groups. Results In the HIVIG treatment group, the recovery time of hypothalamus, disturbance of muscle tone, disturbance of consciousness, original reflex, and respiratory rhythm were shorter than those of the control group, with significant difference. None of the neonates who received HIVIG had adverse reactions. Conclusion HIVIG can reduce the immunopathological damage induced by hypoxic-ischemic brain damage by reducing the production of inflammatory cytokines, shorten the course of HIE, relieve the main neurological symptoms and improve the short-term prognosis of HIE.