肾病综合征患儿对白喉、百日咳、破伤风和麻疹的血清保护作用。
Seroprotection for Diphtheria, Pertussis, Tetanus and Measles in Children With Nephrotic Syndrome.
机构信息
Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, University of Delhi, New Delhi, India.
Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, University of Delhi, New Delhi, India. Correspondence to: Dr Mukta Mantan, Professor, Department of Pediatrics, Maulana Azad Medical College, New Delhi 110 002, University of Delhi, India.
出版信息
Indian Pediatr. 2021 Mar 15;58(3):233-236.
OBJECTIVE
To determine seroprotective titres for diphtheria, pertussis, tetanus and measles in children with nephrotic syndrome who had received essential immunization.
METHODS
Children (2-18 years) with steroid sensitive nephrotic syndrome (SSNS) or steroid-resistant nephrotic syndrome (SRNS) who were in disease remission and had received essential childhood immunization were included. Anti-diphtheria, anti-pertussis, anti-tetanus and anti-measles antibody titres were measured.
RESULTS
Seventy-six (40 with SSNS; 36 with SRNS) children with mean (SD) age 7.54 (3.96) years were enrolled. The time elapsed since last vaccination was >5 years in 68.4% patients. The seroprotection rates for diphtheria, tetanus, pertussis, and measles were 86.8%, 93.4%, 31.6% and 77.6% respectively; lower in SRNS subjects compared to SSNS. Robust seroprotection titers (1.0 IU/mL) for diphtheria were seen in 23.8% SSNS and 17.9% SRNS; P=0.04, and for tetanus in 69.3% SSNS and 43.8% of SRNS subjects; P=0.03, respectively.
CONCLUSIONS
Children with nephrotic syndrome especially those with SRNS have lower seroprotective titers for diphtheria, tetanus, pertussis and measles, necessitating a booster dose of DPT/DT/Td and MR/MMR.
目的
确定肾病综合征患儿接受基本免疫接种后对白喉、百日咳、破伤风和麻疹的血清保护性抗体滴度。
方法
纳入处于疾病缓解期且接受过基本儿童免疫接种的肾病综合征患儿（肾病综合征患儿，肾病综合征患儿）。测量抗白喉、抗百日咳、抗破伤风和抗麻疹抗体滴度。
结果
共纳入 76 名（SSNS40 名，SRNS36 名）年龄为 7.54（3.96）岁的儿童。68.4%的患儿最后一次接种疫苗时间>5 年。白喉、破伤风、百日咳和麻疹的血清保护率分别为 86.8%、93.4%、31.6%和 77.6%；SRNS 组低于 SSNS 组。SSNS 患儿中，有 23.8%和 SRNS 患儿中有 17.9%的患儿对白喉具有较强的血清保护抗体滴度（1.0IU/mL）；P=0.04，SSNS 患儿中有 69.3%和 SRNS 患儿中有 43.8%的患儿对破伤风具有较强的血清保护抗体滴度；P=0.03。
结论
肾病综合征患儿，尤其是 SRNS 患儿对白喉、破伤风、百日咳和麻疹的血清保护性抗体滴度较低，需要加强 DPT/DT/Td 和 MR/MMR 的接种。
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