Du Min, Shang Lihong, Li Xin, Huang Rongna, Yao Haibo, Yang Sheng, Zhao Sujing, Zhang Libing, Xie Xiaoli
Department of Pediatric Gastroenterology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Chengdu Center for Disease Control and Prevention, Chengdu, China.
Transl Pediatr. 2024 Jun 30;13(6):877-888. doi: 10.21037/tp-24-109. Epub 2024 Jun 27.
The clinical features and prognosis of intussusception in children vaccinated against rotavirus were undefined. Hence, we conducted the study to explore the clinical characteristics and outcomes of primary intussusception patients who received rotavirus vaccine.
A single-center retrospective study was performed in 327 primary intussusception patients between January 2019 and December 2021. Of these, 168 were vaccinated against rotavirus and 159 were not, the latter serving as the control group. Data on patients' clinical characteristics, commonly used inflammatory biomarkers, treatment, and outcomes were collected and evaluated.
Most of the vaccination group received pentavalent rotavirus vaccine produced by Merck, USA (89.88%). There were no differences in demographic characteristics, time from onset to hospital attendance, clinical symptoms and signs between the vaccination group and the control group. The success rate of air enema reduction in the vaccination group was higher than that in the control group (98.21% . 88.68%, q=0.01). The vaccination group had lower rates of surgery and complication (1.79% . 11.32%, q=0.008; 2.98% . 12.58%, q=0.006). Both platelet-lymphocyte ratio (PLR) and C-reactive protein (CRP) levels were lower in the vaccinated group (q=0.02, q=0.004). Higher CRP level [odds ratio (OR): 1.635; 95% confidence interval (CI): 1.248-2.143; P=0.006] and the longer time from onset to hospital attendance (OR: 3.040; 95% CI: 2.418-12.133; P=0.01) were associated with increased adverse events. Rotavirus vaccination (OR: 0.527; 95% CI: 0.103-0.751; P=0.02) was associated with a reduction in the probability of adverse events.
Adverse events such as surgery and complications were lower in the vaccination group. Rotavirus vaccination was an independent protective factor for adverse events in patients with primary intussusception.
接种轮状病毒疫苗的儿童肠套叠的临床特征和预后尚不明确。因此，我们开展了这项研究，以探讨接种轮状病毒疫苗的原发性肠套叠患者的临床特征和结局。
对2019年1月至2021年12月期间的327例原发性肠套叠患者进行了单中心回顾性研究。其中，168例接种了轮状病毒疫苗，159例未接种，后者作为对照组。收集并评估患者的临床特征、常用炎症生物标志物、治疗及结局等数据。
接种组大多数患者接种的是美国默克公司生产的五价轮状病毒疫苗（89.88%）。接种组与对照组在人口统计学特征、发病至就诊时间、临床症状和体征方面均无差异。接种组空气灌肠复位成功率高于对照组（98.21%对88.68%，q = 0.01）。接种组的手术率和并发症发生率较低（1.79%对11.32%，q = 0.008；2.98%对12.58%，q = 0.006）。接种组的血小板淋巴细胞比值（PLR）和C反应蛋白（CRP）水平均较低（q = 0.02，q = 0.004）。较高的CRP水平[比值比（OR）：1.635；95%置信区间（CI）：1.248 - 2.143；P = 0.006]以及较长的发病至就诊时间（OR：3.040；95% CI：2.418 - 12.133；P = 0.01）与不良事件增加相关。轮状病毒疫苗接种（OR：0.527；95% CI：0.103 - 0.751；P = 0.02）与不良事件发生概率降低相关。
接种组的手术及并发症等不良事件发生率较低。轮状病毒疫苗接种是原发性肠套叠患者不良事件的独立保护因素。
