《国际指南：静脉注射免疫球蛋白在治疗Rh和ABO新生儿溶血病中的作用》解读

Interpretation of "International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn"

摘要:

《国际指南：静脉注射免疫球蛋白在治疗Rh和ABO新生儿溶血病中的作用》由血液学家、新生儿科医生和输血科专家共同组成的国际专家小组起草，2022年3月16日发表于《英国血液学杂志》。该指南针对静脉注射免疫球蛋白（intravenous immunoglobulin，IVIG）用于Rh和ABO新生儿溶血病进行了循证证据总结并提出了推荐意见。该指南推荐IVIG不应常规应用于Rh和ABO新生儿溶血病以减少换血（exchange transfusion，ET）；在合并严重高胆红素血症（接近或超过ET阈值）或无法实施ET的情况下，IVIG的最佳使用时机尚不明确。该指南制定方法规范严谨，但现有的证据质量等级不高。

Abstract:

International guidelines regarding the role of intravenous immunoglobulin (IVIG) in the management of Rh- and ABO-mediated haemolytic disease of the newborn was drafted by an international panel of experts in the fields of hematology, neonatology, and blood transfusion and was published in British Journal of Haematology on March 16, 2022. The guidelines summarize the evidence-based practice of IVIG in Rh- and ABO-mediated haemolytic disease of the newborn and propose related recommendations. The guidelines recommend that IVIG should not be applied as a routine treatment regimen for Rh- and ABO-mediated haemolytic disease of the newborn in order to reduce exchange transfusion (ET), and the best time to apply IVIG remains unclear in the situations where hyperbilirubinaemia is severe (approaching or exceeding the ET threshold) or ET cannot be implemented. These guidelines are formulated with rigorous methods, but with the lower quality of evidence.