靜脈注射丙種球蛋白治療新生兒溶血癥的系統評價_《中國循證醫學雜志》

作者：

李茂軍 ,  陳昌輝 , 吳青 , 石偉 , 陽倩 , 李夢妮

四川省醫學科學院?四川省人民醫院兒科（成都 610072）;

關鍵詞：

新生兒溶血病靜脈注射用丙種球蛋白隨機對照試驗系統評價 Meta分析

DOI：

10.7507/1672-2531.20100570

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　評價靜脈注射丙種球蛋白（intravenous immunoglobulin G，IVIG）治療新生兒溶血癥的療效。
方法　采用Cochrane系統評價方法，檢索Cochrane圖書館臨床對照試驗資料庫、MEDLINE（1966～2008.05）、EMbase（1992～2008.05）、中國生物醫學文獻光盤數據庫（1979.11～2008.05）及所獲文獻的參考文獻，篩選所有應用IVIG治療新生兒溶血癥的隨機對照試驗（RCT）。按照納入與排除標準由兩名評價員獨立選擇文獻、評介質量、提取資料并交叉核對，而后采用RevMan 4.2軟件進行Meta分析。
結果　共納入6個RCT，合計375例患者。Meta分析結果顯示：IVIG治療新生兒溶血癥可顯著減少換血例數［RR=0.27，95%CI（0.18，0.42）］；IVIG組留院時間比單純光療組明顯減少［WMD= –1.11，95%CI（–1.60，–0.63）］，所需光療時間也顯著減少［WMD= –0.82，95%CI（–1.16，–0.47）］。
結論　在新生兒溶血癥治療中，IVIG能有效減少換血數、光療時間和留院時間，值得推薦使用。開展有嚴格的試驗設計，多中心、大樣本的臨床試驗有助于進一步明確IVIG在新生兒溶血癥治療中的有效性和安全性。

引用本文： 李茂軍,陳昌輝,吳青,石偉,陽倩,李夢妮. 靜脈注射丙種球蛋白治療新生兒溶血癥的系統評價. 中國循證醫學雜志, 2010, 10(10): 1199-1204. doi: 10.7507/1672-2531.20100570 復制

1.	Maisels JM. Neonatal jaundice. Ped in Rev, 2006, 27(12): 443-454.
2.	Bhutani VK, Johnson L. Kernicterus in the 21st century: frequently asked questions. Journal of Perinatology, 2009, 29: S20-S24.
3.	Maisels MJ, McDonagh AF. Phototherapy for neonatal jaundice. N Engl J Med, 2008, 358(9): 920-928.
4.	Newman TB, Liljestrand P, Jeremy RJ, et al. Outcomes among newborns with total serum bilirubin levels of 25 mg per deciliter or more. N Engl J Med, 2006, 354(18): 1889-900.
5.	Williams Y, Lynch S, McCann S, et al. Correlation of platelet Fc gammaRIIA polymorphism in refractory idiopathic (immune) thrombocytopenic purpura. Br J Haematol, 1998, 101(4): 779-782.
6.	Rosse WF, Hillmen P, Schreiber AD. Immune-mediated hemolytic anemia. Hematology Am Soc Hematol Educ Program, 2004, 48-62.
7.	American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 2004, 114(1): 297-316.
8.	Gottstein R, Cooke RW. Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed, 2003, 88(1): F6-F10.
9.	Alcock GS, Liley H. Systematic review: Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates. Cochrane Database Syst Rev, 2002, (3): CD003313.
10.	Alpay F, Sarici SÜ, Okutan V, et al. High-dose intravenous immunoglobulin therapy in neonatal immune haemolytic jaundice. Acta Paediatr, 1999, 88(2): 216-219.
11.	Dagoglu T, Ovali F, Samaci N, et al. High-dose intravenous immunoglobulin therapy for rhesus haemolytic disease. J Int Med Res, 1995, 23(4): 264-271.
12.	Rübo J, Albrecht K, Lasch P, et al. High-dose intravenous immuneglobulin therapy for hyperbilirubinemia caused by Rh hemolytic disease. J Pediatr, 1992, 121(1): 93-97.
13.	Voto LS, Sexer H, Ferreiro G, et al. Neonatal administration of high-dose intravenous immunoglobulin in rhesus hemolytic disease. J Perinat Med, 1995, 23(6): 443-451.
14.	Miqdad AM, Abdelbasit OB, Shaheed MM, et al. Intravenous immunoglobulin G (IVIG) therapy for significant hyperbilirubinemia in ABO hemolytic disease of the newborn. J Matern Fetal Neonatal Med, 2004, 16(3): 163-166.
15.	Nasseri F, Mamouri GA, Babaei H. Intravenous immunoglobulin in ABO and Rh hemolytic diseases of newborn. Saudi Med J, 2006, 27(12): 1827-1830.
16.	Tanyer G, SiklarZ, Dallar Y, et al. Multiple dose IVIG treatment in neonatal immune hemolytic jaundice. J Trop Pediatr, 2001, 47(1): 50-53.
17.	Girish G, Chawla D, Agarwal R, et al. Efficacy of two dose regimes of intravenous immunoglobulin in Rh hemolytic disease of newborn--a randomized controlled trial. Indian Pediatr, 2008, 45(8): 653-659.

1. Maisels JM. Neonatal jaundice. Ped in Rev, 2006, 27(12): 443-454.
2. Bhutani VK, Johnson L. Kernicterus in the 21st century: frequently asked questions. Journal of Perinatology, 2009, 29: S20-S24.
3. Maisels MJ, McDonagh AF. Phototherapy for neonatal jaundice. N Engl J Med, 2008, 358(9): 920-928.
4. Newman TB, Liljestrand P, Jeremy RJ, et al. Outcomes among newborns with total serum bilirubin levels of 25 mg per deciliter or more. N Engl J Med, 2006, 354(18): 1889-900.
5. Williams Y, Lynch S, McCann S, et al. Correlation of platelet Fc gammaRIIA polymorphism in refractory idiopathic (immune) thrombocytopenic purpura. Br J Haematol, 1998, 101(4): 779-782.
6. Rosse WF, Hillmen P, Schreiber AD. Immune-mediated hemolytic anemia. Hematology Am Soc Hematol Educ Program, 2004, 48-62.
7. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 2004, 114(1): 297-316.
8. Gottstein R, Cooke RW. Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed, 2003, 88(1): F6-F10.
9. Alcock GS, Liley H. Systematic review: Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates. Cochrane Database Syst Rev, 2002, (3): CD003313.
10. Alpay F, Sarici SÜ, Okutan V, et al. High-dose intravenous immunoglobulin therapy in neonatal immune haemolytic jaundice. Acta Paediatr, 1999, 88(2): 216-219.
11. Dagoglu T, Ovali F, Samaci N, et al. High-dose intravenous immunoglobulin therapy for rhesus haemolytic disease. J Int Med Res, 1995, 23(4): 264-271.
12. Rübo J, Albrecht K, Lasch P, et al. High-dose intravenous immuneglobulin therapy for hyperbilirubinemia caused by Rh hemolytic disease. J Pediatr, 1992, 121(1): 93-97.
13. Voto LS, Sexer H, Ferreiro G, et al. Neonatal administration of high-dose intravenous immunoglobulin in rhesus hemolytic disease. J Perinat Med, 1995, 23(6): 443-451.
14. Miqdad AM, Abdelbasit OB, Shaheed MM, et al. Intravenous immunoglobulin G (IVIG) therapy for significant hyperbilirubinemia in ABO hemolytic disease of the newborn. J Matern Fetal Neonatal Med, 2004, 16(3): 163-166.
15. Nasseri F, Mamouri GA, Babaei H. Intravenous immunoglobulin in ABO and Rh hemolytic diseases of newborn. Saudi Med J, 2006, 27(12): 1827-1830.
16. Tanyer G, SiklarZ, Dallar Y, et al. Multiple dose IVIG treatment in neonatal immune hemolytic jaundice. J Trop Pediatr, 2001, 47(1): 50-53.
17. Girish G, Chawla D, Agarwal R, et al. Efficacy of two dose regimes of intravenous immunoglobulin in Rh hemolytic disease of newborn--a randomized controlled trial. Indian Pediatr, 2008, 45(8): 653-659.

《中國循證醫學雜志》

靜脈注射丙種球蛋白治療新生兒溶血癥的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

靜脈注射丙種球蛋白治療新生兒溶血癥的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料