目的 研究人免疫球蛋白聯(lián)合注射用鹽酸去甲萬古霉素對(duì)新生兒敗血癥免疫功能和外周血清炎性因子的影響。方法 選擇2013年1月—2017年12月在荊州市中心醫(yī)院進(jìn)行診治的61例新生兒敗血癥患兒作為研究對(duì)象，隨機(jī)分為對(duì)照組（31例）和觀察組（30例）。對(duì)照組患兒靜脈滴注注射用鹽酸去甲萬古霉素，對(duì)于日齡<7 d的新生兒靜脈滴注的劑量為10 mg/kg，2次/d，對(duì)于日齡>7 d的新生兒靜脈滴注的劑量為10 mg/kg，3次/d；觀察組在對(duì)照組基礎(chǔ)上聯(lián)合靜脈滴注人免疫球蛋白，每天400 mg/kg，兩組均治療5 d。觀察兩組患兒的臨床療效，比較兩組住院時(shí)間、癥狀改善時(shí)間及治療前后的外周血清炎性因子水平、免疫功能指標(biāo)。結(jié)果 治療后，觀察組的有效率為86.67%，明顯高于對(duì)照組的67.74%，兩組有效率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，觀察組神經(jīng)系統(tǒng)癥狀改善時(shí)間、住院時(shí)間、拒奶改善時(shí)間以及體溫改善時(shí)間均明顯短于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組外周血清白介素（IL）-6、腫瘤壞死因子-α（TNF-α）、IL-23水平均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組以上指標(biāo)明顯低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組CD4⁺/CD8⁺、CD3⁺和CD4⁺均明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組免疫功能指標(biāo)明顯高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 人免疫球蛋白聯(lián)合注射用鹽酸去甲萬古霉素可有效改善新生兒敗血癥的免疫功能，降低外周血清炎性因子水平，提高臨床效率，值得臨床推廣應(yīng)用。

Objective To investigate the effect of Human Immunoglobulin combined with Norvancomycin Hydrochloride for Injection on immune function and peripheral serum inflammatory factors in neonatal septicemia. Methods Patients (61 cases) with neonatal septicemia in Jingzhou Central Hospital from January 2013 to December 2017 were divided into control (31 cases) and observation (30 cases) group randomly. Children in the control group was intravenous drip of Norvancomycin Hydrochloride for Injection, the intravenous infusion dose was 10 mg/kg for newborns younger than 7 days of age, twice daily, and 10 mg/kg for newborns older than 7 days of age, three times daily. Children in the observation group were iv administered with Human Immunoglobulin on the basis of control group, 400 mg/kg daily. Children in two groups were treated for 5 d. After treatment, clinical efficacy was observed, and the hospitalization time, symptoms improvement time, and the levels of inflammatory factors and immune function indexes before and after treatment in two groups were compared. Results After treatment, the clinical efficacy in the observation was 86.67%, which was significantly higher than 67.74% in the control group, and there was difference between two groups (P<0.05). After treatment, the time of nervous system symptoms improvement, hospitalization, and the improvement time of refusing milk and temperature in the observation group were significantly shorter than those in the control group, and there was difference between two groups (P<0.05). After treatment, the levels of IL-6, TNF-α, and IL-23 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And these indexes in the observation group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, CD4⁺/CD8⁺, CD3⁺ and CD4⁺ in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the immune function indexes in the observation group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Human Immunoglobulin combined with Norvancomycin Hydrochloride for Injection can effectively improve the immune function of neonatal septicemia, reduce the level of peripheral serum inflammatory factors, and improve the effective rate of treatment. It is worthy of clinical application.