Annus T, Montgomery S M, Riikjärv M-A, Björkstén B
Tartu University Children's Hospital, Tartu, Estonia.
Allergy. 2004 Oct;59(10):1068-73. doi: 10.1111/j.1398-9995.2004.00557.x.
Published data about a relationship of atopic diseases to Bacillus Calmette-Guérin (BCG) vaccination and tuberculin responses are inconsistent. Our aim was to determine this association in a country with a low prevalence of allergies.
A random sample of 10-11-year-old schoolchildren in Tallinn was studied by a parental questionnaire (n = 979) and skin-prick tests (n = 643), according to the International Study of Asthma and Allergies in Childhood. Data about BCG vaccinations and tuberculin tests were obtained from school records (n = 723).
The prevalence of allergic symptoms and atopy was similar in children vaccinated during the first month of life and later. Positive tuberculin responses (> or =5 mm) were inversely related to symptoms of asthma [odds ratio (OR) 0.10 (95% confidence interval 0.00-0.68) for exercise-induced wheezing; OR 0.37 (0.12-0.99) for night cough], and eczema [OR 0.53 (0.28-0.98)] but not to atopy. However, among BCG-revaccinated children, atopy tended to be more common in tuberculin responders, and the atopic children were significantly more likely to have a positive tuberculin response after the revaccination than would be predicted by their first test.
We found no protective effect of early BCG vaccination against atopy in school age, although tuberculin responses and allergic symptoms were inversely related.
关于过敏性疾病与卡介苗（BCG）接种及结核菌素反应之间关系的已发表数据并不一致。我们的目的是在一个过敏症患病率较低的国家确定这种关联。
根据儿童哮喘和过敏国际研究，通过家长问卷（n = 979）和皮肤点刺试验（n = 643）对塔林10至11岁的学童进行随机抽样研究。卡介苗接种和结核菌素试验的数据从学校记录中获取（n = 723）。
出生后第一个月内接种疫苗和之后接种疫苗的儿童中，过敏症状和特应性疾病的患病率相似。结核菌素阳性反应（≥5毫米）与哮喘症状呈负相关[运动诱发性喘息的比值比（OR）为0.10（95%置信区间0.00 - 0.68）；夜间咳嗽的OR为0.37（0.12 - 0.99）]，与湿疹[OR为0.53（0.28 - 0.98）]也呈负相关，但与特应性疾病无关。然而，在再次接种卡介苗的儿童中，结核菌素反应者中特应性疾病往往更常见，并且再次接种后，特应性儿童结核菌素呈阳性反应的可能性明显高于首次试验预测的结果。
我们发现，尽管结核菌素反应与过敏症状呈负相关，但在学龄期，早期接种卡介苗对特应性疾病并无保护作用。
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