目的 观察茵栀黄口服液对血型抗体高效价孕妇免疫功能的影响及临床治疗的安全性。方法 将2014年6月—2015年12月收治的50例高效价孕妇(ABO抗体效价≥256,Rh抗体效价≥16)随机分为观察组27例及对照组23例,对照组给予临床常规治疗,观察组在对照组基础上联合茵栀黄口服液治疗,测定两组治疗前后抗体效价水平及外周血淋巴细胞计数的变化,观察新生儿溶血情况,并对治疗的安全性及不良反应进行综合评价。结果观察组总有效率显著高于对照组(P〈0.05)。观察组治疗后ABO和Rh抗体效价低于治疗前及对照组(P〈0.05)。观察组治疗2个月及4个月时CD4+/CD8+、CD16+/CD56+、CD4+和CD19+均低于治疗前,且治疗4个月时低于2个月时(P〈0.05);CD8+高于治疗前,且治疗4个月时高于2个月时(P〈0.05)。治疗2个月及4个月时观察组CD4+/CD8+、CD16+/CD56+、CD4+和CD19+均低于对照组,而CD8+高于对照组(P〈0.05)。观察组新生儿溶血病阳性率显著低于对照组(P〈0.05)。观察组产后新生儿总胆红素和间接胆红素水平低于对照组,而血红蛋白水平高于对照组(P〈0.05)。结论 茵栀黄口服液能够有效抑制孕妇的免疫功能,对血型抗体高效价孕妇具有较好的临床辅助治疗价值。
Objective To investigate effect of Yinzhihuang oral liquid on immunologic function of pregnant women with high-titer blood group antibody and its safety in clinical treatment. Methods A total of 50 pregnant women with high-titer( ABO antibody titer ≥256,Rh antibody titer ≥16) during June 2014 and December 2015 were randomly divided into observation group( n = 27) and control group( n = 23). The control group received routine therapy,while observation group was added with Yinzhihuang oral liquid treatment on the basis of treatment of control group. Changes of antibody titer level and peripheral blood lymphocyte count before and after treatment were detected in two groups. Haemolysis conditions of newborn were observed,and the conditions of safety and adverse reaction for treatment were comprehensively evaluated in two groups. Results In observation group,the total effective rate was significantly higher( P〈0. 05),and ABO and Rh antibody titer levels were lower than those before treatment and in control group( P〈0. 05). In observation group,the amounts of CD4 + / CD8 +,CD16 + / CD56 +,CD4 + and CD19 + after treatment for 2 and 4months were reduced compared with those before treatment,and the amount after treatment for 4 months was lower than that after treatment for 2 months( P〈0. 05); CD8 + amounts after treatment for 2 and 4 months were increased compared with those before treatment,and the amount after treatment for 4 months was higher than that after treatment for 2months( P〈0. 05). The amounts of CD4 + / CD8 +,CD16 + / CD56 +,CD4 + and CD19 + were reduced,while CD8 + amounts were increased after treatment for 2 and 4 months in observation group compared with those in control group( P〈0. 05). In observation group,the positive rate of hemolytic disease of the newborn( HDN) was lower( P〈0. 05),the levels of total bilirubin and indirect bilirubin of newborn were lower,while the hemoglobin( Hb) level was higher compared with tho