在怀孕期间高剂量免疫球蛋白用于重复的新生儿血红色素病
Peter F Whitington1, Judith U Hibbard
1Department of Pediatrics, Feinberg School of Medicine of Northwestern University, 2300 Children's Plaza Box 57, Children's Memorial Hospital, Chicago, IL 60614, USA. p-whitington@northwestern.edu
Lancet (London, England)
|November 9, 2004
概括
在怀孕期间高剂量静脉注射免疫球蛋白 (IVIG) 治疗改善了新生儿复发性血红色的结果. 这种治疗预防了致命的胎儿结果,支持这种罕见的妊娠疾病的非免疫原因.
科学领域:
- 周围生理学 周围生理学
- 免疫学 免疫学 免疫学
- 遗传学 是一个遗传学.
背景情况:
- 新生儿血液染色症是一种罕见的妊娠并发症,导致严重的胎儿肝损伤.
- 家庭中高复发率表明一种非免疫病因.
- 对新生儿复发性血色素瘤的新疗法进行研究至关重要.
研究的目的:
- 评估高剂量静脉注射免疫球蛋白 (IVIG) 在预防或减轻重复的新生儿血红色的疗效.
- 评估IVIG对胎儿存活率和随后怀孕的疾病严重程度的影响.
- 为了进一步证实复发新生儿血色素病的非免疫机制.
主要方法:
- 从怀孕第18周开始,有新生儿血色素病史的孕妇每周接受高剂量IVIG (1g/kg).
- 治疗怀孕的结果与以前受影响怀孕的历史对照进行了比较.
- 评估了婴儿存活率,体检,出生体重和肝脏损伤指标.
主要成果:
- 所有16个接受治疗的怀孕都以正常的体检和适当的出生体重导致活产.
- 12名婴儿显示肝脏受损的证据,但所有婴儿都幸存下来,在随访时都健康.
- 与历史对照相比,孕期IVIG治疗显著改善了婴儿存活率 (15/15对2/15;p=0.0009).
结论:
- 在怀孕期间服用高剂量的IVIG似乎可以修改重复的新生儿血色素瘤,防止致命的胎儿和新生儿结局.
- 这些发现支持了潜在的复发性新生儿血色素病的非免疫机制的假设.
- 试管婴儿输卵管治疗对于有这种严重疾病风险的孕妇来说是一个有前途的干预措施.
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