静注大剂量丙种球蛋白与溶血病新生儿坏死性小肠结肠炎发生关系的研究
Study on the Relationship between Intravenous Injection of Large Doses of Intravenous Immunoglobulin and Necrotizing Enterocolitis in Neonates with Hemolytic Disease
摘要: 目的：通过对足月ABO溶血病新生儿静注大剂量丙种球蛋白后血清I-FABP、D-Lac水平的测定，探讨静注大剂量丙种球蛋白与溶血病新生儿坏死性小肠结肠炎发生的关系。方法：选择2018年12月至2019年12月我院新生儿科收治的足月ABO溶血病患儿60例，分为实验组及对照组。采用酶联免疫吸附法(ELISA)检测不同时间点血清中I-FABP、D-Lac水平，比较不同组内、组间血清I-FABP、D-Lac水平变化。结果：实验组血清I-FABP水平分别为：(1.45 ± 0.26) ng/ml、(3.78 ± 0.38) ng/ml和(3.39 ± 0.44) ng/ml，组内比较差异有统计学意义(P < 0.05)；对照组血清I-FABP水平分别为：(1.34 ± 0.23) ng/ml、(1.43 ± 0.17) ng/ml和(1.43 ± 0.18) ng/ml，组内比较差异无统计学意义(P > 0.05)；两组组间比较：F = 530.188, P < 0.05提示差异有统计学意义，实验组血清D-Lac水平分别为(3.93 ± 1.0) ug/ml、(7.42 ± 1.1) ug/ml和(7.88 ± 1.1) ug/ml，组内比较差异有统计学意义(P < 0.05)；对照组血清D-Lac水平分别为：(3.78 ± 0.75) ug/ml、(3.66 ± 0.66) μg/ml、(3.70 ± 0.85) μg/ml，组内比较差异无统计学意义(P > 0.05)；两组组间比较差异有统计学意义(F = 300.0, P < 0.05)。实验分析中检测时间与分组因素存在交互作用，通过简单效应的程序分析，提示差异主要与分组因素相关。结论：静注大剂量丙种球蛋白可引起肠道粘膜损伤，是溶血病新生儿NEC发生的一个高危因素。
Abstract: Objective: To investigate the relationship between high dose of Intravenous immunoglobulin and necrotizing enterocolitis in neonates with full-term hemolytic disease (ABO) by measuring the serum I-FABP and D-LAC levels after intravenous injection of high dose intravenous immunoglobulin. Methods: A total of 60 children with full-term ABO hemolytic disease admitted to the neonatal department of our hospital from December 2018 to December 2019 were selected and divided into the experimental group and the control group. Serum I-FABP and D-LAC levels were detected by enzyme-linked immunosorbent assay (ELISA) at different time points, and the changes of serum I-FABP and D-LAC levels in different groups and between groups were compared. Results: The levels of serum I-FABP in the experimental group were (1.45 ± 0.26) ng/ml, (3.78 ± 0.38) ng/ml and (3.39 ± 0.44) ng/ml, respectively, with statistical significance within the groups (P < 0.05). Serum I-FABP levels in the control group were (1.34 ± 0.23) ng/ml, (1.43 ± 0.17) ng/ml and (1.43 ± 0.18) ng/ml, respectively, and there was no significant difference between the two groups (P > 0.05). Comparison between the two groups: F = 530.188, P < 0.05 indicated a statistically significant difference. Serum D-LAC levels of the experimental group were (3.93 ± 1.0) ug/ml, (7.42 ± 1.1) ug/ml and (7.88 ± 1.1) ug/ml, respectively, and the difference within the groups was statistically significant (P < 0.05). The serum D-LAC levels in the control group were (3.78 ± 0.75) ug/ml, (3.66 ± 0.66) μg/ml and (3.70 ± 0.85) μg/ml, respectively, and there was no significant difference between the two groups (P > 0.05). The difference between the two groups was statistically significant (F = 300.0, P < 0.05). In the experimental analysis, there was an interaction between detection time and grouping factors. Through the program analysis of simple effect, it was suggested that the difference was mainly related to grouping factors. Conclusions: Intravenous large doses of immunoglobulin can cause intestinal mucosal damage, which is a high risk factor for NEC in neonates with hemolytic disease.
文章引用：王孟兰, 姜红. 静注大剂量丙种球蛋白与溶血病新生儿坏死性小肠结肠炎发生关系的研究[J]. 临床医学进展, 2021, 11(3): 1095-1101. https://doi.org/10.12677/ACM.2021.113156

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