丙种球蛋白联合光疗对ABO溶血患儿血清前白蛋白和总胆汁酸的影响
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篇名: 丙种球蛋白联合光疗对ABO溶血患儿血清前白蛋白和总胆汁酸的影响
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摘要: 目的:探讨丙种球蛋白联合光疗对ABO溶血患儿血清前白蛋白(PAB)和总胆汁酸(TBA)的影响及安全性。方法:选择2014年2月-2016年9月我院治疗的ABO溶血患儿90例作为研究对象,按随机数字表法分为观察组和对照组,各45例。两组患儿均常规积极纠正缺氧,对可能出现的低血糖及低体温做好预防处理。对照组患儿另给予波长为425~475 nm的蓝光进行光疗;观察组患儿在对照组的基础上给予静注人免疫球蛋白(pH4)1.0g/kg加入生理盐水10 mL中,ivgtt,治疗1 d。对比两组患儿的黄疸消退时间、光疗时间、住院时间及治疗前后PAB、TBA水平,并记录不良反应发生情况。结果:观察组患儿的黄疸消退时间、光疗时间、住院时间均显著短于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患儿PAB、TBA水平比较,差异无统计学意义(P>0.05);治疗后,两组患儿PAB水平显著升高,TBA水平显著降低,且观察组显著优于对照组,差异均有统计学意义(P<0.05)。两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论:丙种球蛋白联合光疗能显著缩短ABO溶血患儿临床症状改善时间,升高血清PAB水平,降低血清TBA水平,且安全性较高。
ABSTRACT: OBJECTIVE: To investigate the effects and safety of gamma globulin combined with phototherapy on serum prealbumin (PAB) and total bile acid (TBA) of ABO hemolytic children. METHODS: A total of 90 ABO hemolytic children in our hospital during Feb. 2014-Sept. 2016 were selected as research objects and divided into observation group and control group according to random number table, with 45 cases in each group. Both groups were given routine active correction of hypoxia and pretreatment for possible hypoglycemia and hypothermia. Control group was additionally given phototherapy with wavelength of 425-475 nm. Observation group was additionally given Human immunoglobulin for intravenous injection (pH4) 1.0g/kg was added to normal saline 10 mL, ivgtt, on the ?basis of control group and treated for 1 d. The time of jaundice regression, phototherapy duration and hospitalization time were compared between 2 groups, and the levels of PAB and TBA were compared before and after treatment. The occurrence of ADR was recorded in 2 groups. RESULTS: The time of jaundice regression, phototherapy duration and hospitalization time in observation group were significantly shorter than control group, with statistical significance (P<0.05). Before treatment, there was no statistical significance in the levels of PAB or TBA between 2 groups (P>0.05). After treatment, the level of PAB was increased significantly in 2 groups, while the level of TBA was decreased significantly; the observation group was significantly better than the control group, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS: Gamma globulin combined with phototherapy can significantly shorten the time of clinical symptom improvement, increase serum level of PAB whlie decrease serum level of TBA in ABO hemolytic children, with good safety.
期刊: 2017年第28卷第35期
作者: 丁慧红,王玉花,杨一,胡蓉,代厚敏,杨兴海
AUTHORS: DING Huihong,WANG Yuhua,YANG Yi,HU Rong,DAI Houmin,YANG Xinghai
关键字: 丙种球蛋白;光疗;新生儿溶血;前白蛋白;总胆汁酸
KEYWORDS: Gamma globulin; Phototherapy; Neonatal hemolysis; PAB; TBA
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