Golden G S
Department of Pediatrics, University of Tennessee, Memphis 38105.
J Pediatr. 1990 Jun;116(6):854-61. doi: 10.1016/s0022-3476(05)80640-7.
A syndrome of pertussis vaccine encephalopathy was first reported 56 years ago. Analysis of the recent literature, however, does not support the existence of such a syndrome and suggests that neurologic events after immunization are chance temporal associations of neurologic conditions that occur in the target age group, even in the absence of immunization. Population-based studies do not prove a causal relationship with acute encephalopathy. There are no consistent neuropathologic findings suggesting a specific pathophysiologic process, and hypotheses concerning possible mechanisms of damage are not supported by reproducible studies in children. No acceptable animal model exists. There clearly is an increased risk of a convulsion after diphtheria-tetanus-pertussis immunization but no evidence that this produces brain injury or is a forerunner of epilepsy. Studies have also not linked immunization with either sudden infant death syndrome or infantile spasms.
56年前首次报道了百日咳疫苗脑病综合征。然而，近期文献分析并不支持存在这样一种综合征，提示免疫接种后的神经系统事件是目标年龄组中发生的神经系统疾病的偶然时间关联，即使在未进行免疫接种的情况下也是如此。基于人群的研究并未证明与急性脑病存在因果关系。没有一致的神经病理学发现提示特定的病理生理过程，关于可能损伤机制的假说也未得到儿童重复性研究的支持。不存在可接受的动物模型。白喉-破伤风-百日咳免疫接种后惊厥风险明显增加，但没有证据表明这会导致脑损伤或为癫痫的先兆。研究也未将免疫接种与婴儿猝死综合征或婴儿痉挛症联系起来。
