贾媛萍,郭海涛,卢 宁,王文燕,李 赟

目的：评价静脉注射免疫球蛋白（Intravenous immunoglobulin，IVIg）治疗神经系统疾病的安全性，为临床在神经系统适应症中使用IVIg前评估用药风险提供参考和循证建议。方法：以范围审查为方法学框架，全面系统检索Cochrane Library、PubMed、Embase、中国期刊全文数据库（CNKI）、万方数据库、中国生物医学文献数据库（SinoMed）的文献以确定相关研究，截至2024年1月17日，收集所有关于IVIg治疗神经系统疾病后相关不良反应的临床研究，并提取、汇总有关信息。结果:最终42篇文献纳入本研究，结果表明文献报告的与IVIg相关的不良反应的发生率差异很大，常见的不良反应包括头痛、皮肤过敏反应、流感样症状、胃肠道反应、实验室参数异常等，基本都是短暂且轻微的，并在停药后缓解。一些罕见且严重的不良反应包括无菌性脑膜炎、血栓栓塞并发症、溶血、肾功能损害等。目前缺乏高质量的数据来确定特定的神经系统适应症与较高的不良反应风险相关，防范措施的有效性证据有限，其中包括预防用药、由静脉给药改为皮下给药、监测相关指标等，可以最大限度地减少这些不良反应。结论:IVIg引起的轻度不良反应在神经系统患者中具有良好的耐受性，发生严重AR的风险较低，未发现导致致残或致命。对IVIg相关不良反应的危险因素可进行早期评估或预防，受影响的患者预后良好。

静脉注射免疫球蛋白；神经系统疾病；不良反应；范围审查

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