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先天性心脏病患儿是否符合疫苗接种建议?先天性心脏病患儿的免疫接种。

Do children with congenital heart defects meet the vaccination recommendations? Immunisation in children with congenital heart defects.

机构信息

Institute of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.

Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany.

出版信息

Cardiol Young. 2022 Jul;32(7):1143-1148. doi: 10.1017/S1047951121003887. Epub 2021 Sep 27.

Abstract

INTRODUCTION

Congenital heart defects (CHDs) are the most common congenital malformations. Patients with CHD have a higher morbidity and mortality rate and are at greater risk for infectious diseases. The risk might even be higher if complex CHD occurs and if CHD is associated with additional co-morbidities. Therefore, immunisations in these children are essential.

MATERIALS AND METHODS

Individuals were recruited at the outpatient centre of the Department of Congenital Heart Defects and Pediatric Cardiology at the German Heart Center Munich in the time between February 2016 and February 2017. Included were children between 23 months and 17 years and a diagnosis of CHD. The vaccination certificate aimed to assess the immunization status.

RESULTS

In total, 657 children with CHD were included and analysed. Regarding primary immunisation, only 34 % (n = 221) of the children reached the complete vaccination status within the allowed catch-up time. Among these primary immunisation rates, vaccinations against Hepatitis B, Meningococci, Varicella and Pneumococci were found to have the lowest coverage with all being below 80%. The vaccination rate was partly influenced by the previously performed number of surgeries but not by the diagnosis of specific genetic diseases. At the age of school entry, the immunisation rate in children with CHD was also lower than in the comparable healthy population.

CONCLUSION

The vaccination coverage rate in children with CHD is lower than in comparable healthy children, although this is a vulnerable patient group. Further education of parents and treating physicians of children with CHD regarding vaccination is still needed.

摘要

简介

先天性心脏病(CHD)是最常见的先天性畸形。CHD 患者的发病率和死亡率较高,感染性疾病的风险也更高。如果发生复杂的 CHD,或者 CHD 伴有其他合并症,风险甚至更高。因此,这些儿童的免疫接种至关重要。

材料和方法

2016 年 2 月至 2017 年 2 月期间,在德国慕尼黑心脏中心先天性心脏病和儿科心脏病科的门诊中心招募了个体。纳入的患儿年龄在 23 个月至 17 岁之间,诊断为 CHD。接种证书旨在评估免疫接种状况。

结果

共纳入并分析了 657 例 CHD 患儿。在初级免疫接种方面,只有 34%(n=221)的儿童在允许的追赶时间内达到完全接种状态。在这些初级免疫接种率中,乙型肝炎、脑膜炎球菌、水痘和肺炎球菌的接种覆盖率最低,均低于 80%。接种率部分受到先前手术次数的影响,但不受特定遗传疾病诊断的影响。在入学年龄时,CHD 患儿的免疫接种率也低于可比健康人群。

结论

尽管 CHD 患儿是一个脆弱的患者群体,但他们的疫苗接种覆盖率低于可比健康儿童。仍需要对 CHD 患儿的家长和治疗医生进行疫苗接种相关的进一步教育。

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