Prophylaxis of intravenous immunoglobulin and acyclovir in perinatal varicella
Prophylaxis of intravenous immunoglobulin and acyclovir in perinatal varicella
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DOI：
10.1007/s004310000640
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发表时间：
2001-02-01
影响因子：
3.6
通讯作者：
Chou, YH
中科院分区：
文献类型：
--
作者：
Huang, YC;Lin, TY;Chou, YH
产妇在分娩时患水痘可导致新生儿严重甚至致命的疾病，但尚未建立有效的预防方法。提示静脉注射免疫球蛋白（IVIG）和无环鸟苷（ACV）联合应用可有效预防围生期水痘。一组24名新生儿，其母亲在分娩前后14天内发生水痘皮疹进行了研究。约15名母亲在分娩前7天和分娩后5天内出现皮疹的婴儿被归类为高危组，并在出生后不久或出生后立即接受IVIG预防（500 mg/kg），单独或与静脉注射阿昔洛韦（5 mg/kg，每8小时一次），从母亲皮疹发作后7天开始共5天。4例单用IVIG的患儿中，2例发生临床水痘，10例同时用IVIG和ACV的患儿均未发生水痘，1例单用ACV的患儿也未发生水痘水疱。在非高危组的9名婴儿中，有4名在入院时检测不到水痘带状疱疹病毒抗体，并发展为临床水痘subsequent.Conclusion静脉注射免疫球蛋白给予出生后不久，预防性阿昔洛韦静脉注射后7天的母亲皮疹可以有效地预防围生期水痘。
Maternal chickenpox around the time of delivery can cause severe and even fatal illness in the newborn but an effectively preventive method has not yet been established. We proposed that a combination of intravenous immunoglobulin (IVIG) and acyclovir (ACV) intravenously could effectively prevent perinatal varicella. A group of 24 newborn infants whose mother had developed a varicella rash within 14 days before and after delivery were studied. Some 15 infants whose mothers' rash appeared within 7 days before and 5 days after delivery were categorised as an at-risk group and received IVIG prophylaxis (500 mg/kg) administered soon after birth or post-natal contact either alone or with intravenous acyclovir (5 mg/kg every 8 h) for a total of 5 days starting from 7 days after the onset of maternal rash. Of four infants receiving IVIG alone, two developed clinical varicella, None of ten infants receiving both IVIG and ACV contracted varicella, One infant receiving ACV alone had no varicella vesicles either. Of nine infants in the not at-risk group four had undetectable varicella-zoster virus antibody on admission and developed clinical varicella subsequently.Conclusion The combination of intravenous immunoglobulin given soon after birth and prophylactic acyclovir intravenously administered 7 days after the onset of maternal rash can effectively prevent perinatal varicella.