【摘要】 目的探讨静脉注射用人血免疫球蛋白(IVIg)对脓毒症相关性血小板减少症的辅助治疗作用。方法将60例出现血小板减少的脓毒症患者分成两组,治疗组在综合治疗的基础上加用IVIg,观察IVIg对患者血管内皮功能、血小板计数、出血倾向的影响。结果治疗组血小板计数在治疗后第3天开始明显高于对照组(P<0.05或P<0.01),出血发生率低于对照组(P<0.01);治疗组APACHEⅢ评分在治疗后第3天开始,血TM、VWF水平在治疗后第5天开始较对照组明显下降(P<0.05或P<0.01)。结论采用IVIg治疗脓毒症相关血小板减少症可减轻患者血管内皮细胞损伤,使血小板计数迅速上升,改善患者的出血倾向。更多还原

【Abstract】 Objective To investigate the effects of intravenous immunoglobulin therapy of thrombocytopenia associated with sepsis. Methods 60 septic thrombocytopenia patients were divided into immunoglobulin group and control group, 30 cases respectively. 400 mg·kg-1·d-1 immunoglobulin was intravenously injected for immunoglobulin group for 5 days besides conventional treatment. Before and after immunoglobulin treatment, platelet(PLT) counts, thrombomodulin (TM), von Willebrand factor(VWF) level and APACHEⅢ were measured. Results Platelet counts were higher after 3-day immunoglobulin treatment in the immunoglobulin group(P<0.05 or P<0.01), but the morbidity of bleeding episode was significantly lower(P<0.01). Compared with the control group, APACHEⅢ on 3rd day, TM and VWF level on 5th day reduced significantly(P<0.05 or P<0.01). Conclusions The use of immunoglobulin to treat septic thrombocytopenia leads to rapid and great increase in platelet counts and significant decrease in the morbidity of bleeding episode, TM and VWF level and APACHEⅢ.更多还原