【摘要】 目的 报道儿童静注人免疫球蛋白(human immunoglobulin for intravenous injection,IVIG)输注致严重溶血不良反应，提示临床应警惕IVIG相关溶血反应，保障儿童输血安全。方法 对1例重症肺炎患儿输注大剂量IVIG后，发生严重溶血反应病例进行回顾性分析。结果 输注大剂量IVIG后出现严重溶血不良反应，临床表现为血红蛋白降低，胆红素、乳酸脱氢酶进行性升高，肝脏进行性增大;患儿红细胞及血浆检出IgG类抗体。结论 输注IVIG被动获得IgG类抗体时，应及时监测体内抗体效价;输血时，选择规避该抗体的红细胞制品输注，降低溶血反应，警惕罕见的严重溶血不良反应发生。更多还原

【Abstract】 Objective To report severe hemolytic adverse reactions caused by intravenous infusion of human immunoglobulin( IVIG) in a child,and to alert clinical staff to be aware of IVIG-associated hemolytic reactions to ensure transfusion safety in pediatric populations. Methods A retrospective analysis was conducted on a case of severe hemolytic reaction following high-dose IVIG infusion in a pediatric patient with severe pneumonia. Results Following high-dose IVIG infusion,severe hemolytic adverse reactions developed,clinically manifesting as decreased hemoglobin,progressively elevated bilirubin and lactate dehydrogenase( LDH),and gradual hepatomegaly. IgG antibodies were detected in the patient’s erythrocytes and plasma. Conclusion When patients passively acquire IgG antibodies through IVIG infusion,timely monitoring of antibody titers in vivo is critical. For subsequent transfusions,red blood cell products that lack the corresponding antigens should be selected to mitigate hemolysis. Clinicians should remain vigilant against rare but severe hemolytic adverse reactions.更多还原