Guld J, Waaler H, Sundaresan T K, Kaufmann P C, ten Dam H G
Bull World Health Organ. 1968;39(5):829-36.
It had been shown earlier, in a retrospective study, that tuberculin sensitivity is stronger in children tested for the second time after vaccination than in those tested for the first time after vaccination. The hypothesis that the tuberculin test itself may reinforce sensitivity to a further test has now been confirmed in 2 strictly controlled prospective studies, which are reported here. The results refer to the tuberculin reactions 5 years after vaccination. These reactions were significantly larger in children who had had an intermediate test (less than 5 years after vaccination) than in those tested for the first time at 5 years. This was found equally for several BCG products, but there was a significant tendency for the PPD batch RT 19-20-21 to have a more pronounced effect than the other tuberculins.It follows from the results of these studies that a possible waning of tuberculin sensitivity cannot be revealed by regular tuberculin testing. Moreover, experiments in guinea-pigs have shown that restoration of sensitivity by means of an injection of tuberculin does not influence the acquired resistance; there are no particular reasons to believe that this should be different in man. Thus the authors consider the very common practice of giving regular tuberculin tests to vaccinated children, in order to decide on possible revaccination, to be devoid of any scientific basis.
早期一项回顾性研究表明,接种疫苗后第二次接受结核菌素检测的儿童,其结核菌素敏感性比首次接受检测的儿童更强。结核菌素检测本身可能会增强对进一步检测的敏感性这一假说,现已在两项严格对照的前瞻性研究中得到证实,本文对此进行报道。结果涉及接种疫苗5年后的结核菌素反应。接种疫苗后进行过中间检测(接种后不到5年)的儿童,其结核菌素反应明显大于5年后首次接受检测的儿童。几种卡介苗产品均出现这种情况,但PPD批次RT 19 - 20 - 21比其他结核菌素的作用更明显,这一趋势具有统计学意义。从这些研究结果可以推断,定期进行结核菌素检测无法揭示结核菌素敏感性可能出现的减弱。此外,豚鼠实验表明,注射结核菌素恢复敏感性不会影响获得性抵抗力;没有特别理由认为人类会有所不同。因此,作者认为,为了决定是否可能再次接种疫苗而对已接种疫苗的儿童进行定期结核菌素检测这种非常普遍的做法,没有任何科学依据。