标题：丙种球蛋白治疗ABO溶血病患儿的胆红素阈值分析

      作者：韦 伟，卢思稼
    (海南省人民医院新生儿科，海南 海口 570311)

      卷次： 2015年26卷16期

      【摘要】 目的 比较不同胆红素水平的ABO溶血病患儿应用丙种球蛋白(IVIG)治疗的临床疗效，探讨丙种
球蛋白治疗ABO溶血病患儿的胆红素阈值。方法 选择2011年1月至2013年8月期间我院收治的ABO溶血病
患儿102例，按照数字随机法将其分为A组与B组，每组51例。A组在胆红素指标位于Bhutani曲线的75百分位
时应用 IVIG治疗，B组患儿在胆红素指标位于Bhutani曲线的95百分位时应用 IVIG治疗。观察两组间住院率、
住院费用、疗效等方面的差异。结果 A组 IVIG应用率为 81.31%，住院费用为(3 689±985)元，B组 IVIG应用率
为 58.82%，住院费用为(3 241±1 126)元，A组采用 IVIG治疗率和住院费用明显高于B组，两组比较差异均具有
统计学意义(P<0.05)；所有患儿均未采取血白蛋白治疗，两组患儿的总光疗时间、胆红素降低程度、住院时间比
较差异增多无统计学意义(P>0.05)；两组患儿在出生 42 d、入院、出院时的Hb值比较差异均无统计学意义(P>
0.05)。 结论 ABO溶血病患儿胆红素指标在Bhutani曲线中的 95百分位和 75百分位时应用 IVIG治疗疗效相
当，但以胆红素指标在Bhutani曲线中的95百分位作为治疗阈值时 IVIG治疗病例更少，住院费用更低。

      【关键词】 ABO溶血病；丙种球蛋白；疗效；适应证

      【中图分类号】 R722.18 【文献标识码】 A 【文章编号】 1003—6350（2015）16—2385—03


Analysis of bilirubin thresholds of using gamma globulin for treating ABO hemolytic disease.
WEI Wei, LU
Si-jia. People's Hospital of Hainan Province, Haikou 570311, Hainan, CHINA

【Abstract】 Objective To observe the effects of gamma globulin (IVIG) in the treatment of patients of ABO
hemolytic disease with different levels of bilirubin, and to study the threshold of bilirubin. Methods One hundred
and two patients of ABO hemolytic disease treated in our hospital from January 2011 to August 2013 were enrolled in
the study, which were randomly divided into group A and group B, with 51 patients in each group. Group A applied
IVIG when bilirubin index was located at 75% points of the Bhutani curve, while group B applied IVIG at 95% points.
The admission rate, hospitalization expenses, curative effect were compared between the two groups. Results The ap-
plication rate of IVIG, the hospitalization expenses was 81.31%, (3 689±985) RMB in group A, significantly higher
than 58.82%, (3 241±1126) RMB in group B (P<0.05). In this study, all the patients did not received blood albumin
for treatment. The two groups showed no statistically significant difference in total phototherapy time, decrease in bili-
rubin level, and hospitalization time (P>0.05). The two groups also showed no statistically significant difference in Hb
in 42 d after born, at admission and discharge (P>0.05). Conclusion The effect of IVIG treatment is similar when bil-
irubin index is at 95% points and 75% points of Bhutani curve, but the cases of IVIG treatment is less and hospitaliza-
tion expense is lower at 95% points.