Baraff L J, Shields W D, Beckwith L, Strome G, Marcy S M, Cherry J D, Manclark C R
Department of Pediatrics, University of California, Los Angeles, School of Medicine.
Pediatrics. 1988 Jun;81(6):789-94.
In a prior prospective study, we evaluated the nature and rates of adverse reactions occurring within 48 hours following 15,752 diphtheria-tetanus-pertussis (DTP) immunizations. Nine children had convulsions, and nine had hypotonic-hyporesponsive episodes. After an interval of 6 to 7 years, we were successful in contacting the families of 16 of these children to determine whether any had evidence of neurologic impairment too subtle to have been detected at the time of initial evaluation. All 16 were considered normal by their parents and were doing well in school. A complete neurologic and psychometric evaluation was performed on 13 of these children. No child had significant neurologic deficit, although four had minor neurologic abnormalities. Psychometric testing revealed normal performance IQ scores (104.3 +/- 15.8) but low verbal IQ scores (91.8 +/- 18.4); however, these lower verbal IQ scores can be explained by the proportion of Hispanic and bilingual children in this sample. Therefore, there is no evidence that any of these 16 children have any serious neurologic damage as a result of a convulsion or a hypotonic-hyporesponsive episode temporally associated with a prior diphtheria-tetanus-pertussis immunization.
在一项先前的前瞻性研究中，我们评估了15752次白喉-破伤风-百日咳（DTP）疫苗接种后48小时内出现的不良反应的性质和发生率。9名儿童发生惊厥，9名儿童出现低张力-低反应性发作。间隔6至7年后，我们成功联系到了其中16名儿童的家庭，以确定他们中是否有任何儿童存在在初次评估时过于细微而未被发现的神经功能损害证据。所有16名儿童的父母都认为他们正常，并且在学校表现良好。对其中13名儿童进行了全面的神经学和心理测量评估。没有儿童存在明显的神经功能缺陷，尽管有4名儿童存在轻微的神经学异常。心理测量测试显示，表现智商分数正常（104.3±15.8），但语言智商分数较低（91.8±18.4）；然而，这些较低的语言智商分数可以用该样本中西班牙裔和双语儿童的比例来解释。因此，没有证据表明这16名儿童中的任何一名因惊厥或与先前白喉-破伤风-百日咳疫苗接种暂时相关的低张力-低反应性发作而有任何严重的神经损伤。
