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[结核病的疫苗预防:意义与问题]

[Vaccine prophylaxis of tuberculosis: implication and problems].

作者信息

Aksenova V A, Levi D T, Fonina E V, Vundtsettel' N N

出版信息

Probl Tuberk Bolezn Legk. 2009(1):10-6.

Abstract

The paper presents data on vaccine prophylaxis in Russia. A sophisticated analysis of the data available in the literature on approaches to vaccination against tuberculosis in different countries of the world is provided. The results of the studies made by Russian investigators to develop different regimes of BCG re-administrations an their frequencies are given. The fact that it is necessary to change a tuberculosis prophylaxis calendar under the present conditions, by keeping in mind the age of a child and the epidemic situation in the country's region, has been established. A particular section is dedicated to the problem associated with the occurrence of complications in response to tuberculosis vaccine. Based on the Federal Center data on complications due to BCG/ BCG-M, the authors provide information on the incidence and pattern of complications occurring in Russia. As compared with 1995, the incidence of postvaccination complications slightly changed (21.1 in 100,000 in 1995 versus 20.3 in 2002-2003). In the children inoculated at a maternity hospital, postvaccination lymphadenitis was observed 2 times more frequently than in those vaccinated at a polyclini (77.1 and 37% of cases, respectively) and cold abscesses were 3.3 times less frequently than those inoculated at the polyclinic (19.1 and 63% of cases, respectively). The study has ascertained main reasons for the higher incidence of severe complications as BCG ostitis.

摘要

该论文展示了俄罗斯疫苗预防的数据。对世界不同国家结核病疫苗接种方法的文献数据进行了深入分析。给出了俄罗斯研究人员制定不同卡介苗再接种方案及其频率的研究结果。已确定在当前情况下,有必要根据儿童年龄和该国地区的疫情情况改变结核病预防日程。一个特定章节专门讨论了与结核病疫苗接种后出现并发症相关的问题。基于联邦中心关于卡介苗/卡介苗-多糖核酸引起的并发症的数据,作者提供了俄罗斯并发症的发病率和模式信息。与1995年相比,接种后并发症的发病率略有变化(1995年为每10万人中21.1例,2002 - 2003年为每10万人中20.3例)。在产科医院接种的儿童中,接种后淋巴结炎的发生率比在综合诊所接种的儿童高2倍(分别为病例的77.1%和37%),冷脓肿的发生率比在综合诊所接种的儿童低3.3倍(分别为病例的19.1%和63%)。该研究确定了严重并发症如卡介苗骨炎发病率较高的主要原因。

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