CAJ | 학술논문

目的：探讨静脉注射免疫球蛋白对脓毒症相关性血小板减少症的辅助治疗效果。方法：采用前瞻性随机对照的研究方法，将入选的229例脓毒症且血小板计数＜30×109／L的患者，分为干预组和对照组。对照组采用基础治疗；干预组在基础治疗的基础上加用免疫球蛋白静脉滴注0．4 g／（kg·d），每天1次，连用5 d。统计两组患者在应用免疫球蛋白静滴第1、3、5、7天的血小板计数以及两组患者的ICU留治时间和28 d住院病死率。结果：干预组的患者在应用免疫球蛋白第5天后开始，其血小板升高的幅度明显高于对照组（P ＜0．05）。与对照组相比，干预组的28 d 住院病死率与存活患者的 ICU 留治时间均有明显改善（P ＜0．05）。结论：静脉注射免疫球蛋白对于严重脓毒症伴严重血小板减少症（血小板计数＜30×109／L）的患者，其升高血小板的作用显著，并能明显缩短患者ICU留治时间，降低患者的病死率。
목적：탐토정맥주사면역구단백대농독증상관성혈소판감소증적보조치료효과。방법：채용전첨성수궤대조적연구방법，장입선적229례농독증차혈소판계수＜30×109／L적환자，분위간예조화대조조。대조조채용기출치료；간예조재기출치료적기출상가용면역구단백정맥적주0．4 g／（kg·d），매천1차，련용5 d。통계량조환자재응용면역구단백정적제1、3、5、7천적혈소판계수이급량조환자적ICU류치시간화28 d주원병사솔。결과：간예조적환자재응용면역구단백제5천후개시，기혈소판승고적폭도명현고우대조조（P ＜0．05）。여대조조상비，간예조적28 d 주원병사솔여존활환자적 ICU 류치시간균유명현개선（P ＜0．05）。결론：정맥주사면역구단백대우엄중농독증반엄중혈소판감소증（혈소판계수＜30×109／L）적환자，기승고혈소판적작용현저，병능명현축단환자ICU류치시간，강저환자적병사솔。
Objective To investigate the adjuvant effect of intravenous immunoglobulin on patients with sepsis-associated thrombocytopenia. Methods A total of 229 patients with sepsis with platelet count less than 3 × 109/L, were included in this prospective, randomized, controlled study. The patients were divided into the intervening group and the control group. Conventional treatments were applied in the two both groups , while in the intervening group, intravenous immunoglobulin with a dose of 0.4 g/(kg·d) for 5 consecutive days was administered. The end-points were the platelet counts on day 1,day 3,day 5,and day 7 post-intravenous immunoglobulin, patients’ in-ICU time and the 28-day in-hospital mortality. Results Compared with the control group, the platelet count recovered dramatically after 5-day intravenous immunoglobulin in the intervening group. Moreover , the 28-day in-hospital mortality and in-ICU time were also dramatically improved in the intervening group. Conclusion Intravenous immunoglobulin can enhance the recovery of platelet counts , shorten the in-ICU time and reduce the hospital mortality in patients with sepsis- associated thrombocytopenia (PLT count < 30 × 109/L).