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麻疹疫苗接种是炎症性肠病的一个风险因素吗?

Is measles vaccination a risk factor for inflammatory bowel disease?

作者信息

Thompson N P, Montgomery S M, Pounder R E, Wakefield A J

机构信息

Inflammatory Bowel Disease Study Group, Royal Free Hospital School of Medicine, London, UK.

出版信息

Lancet. 1995 Apr 29;345(8957):1071-4. doi: 10.1016/s0140-6736(95)90816-1.

Abstract

Measles virus may persist in intestinal tissue, particularly that affected by Crohn's disease, and early exposure to measles may be a risk factor for the development of Crohn's disease. Crohn's disease and ulcerative colitis occur in the same families and may share a common aetiology. In view of the rising incidence of inflammatory bowel disease (Crohn's disease and ulcerative colitis), we examined the impact of measles vaccination upon these conditions. Prevalences of Crohn's disease, ulcerative colitis, coeliac disease, and peptic ulceration were determined in 3545 people who had received live measles vaccine in 1964 as part of a measles vaccine trial. A longitudinal birth cohort of 11,407 subjects was one unvaccinated comparison cohort, and 2541 partners of those vaccinated was another. Compared with the birth cohort, the relative risk of developing Crohn's disease in the vaccinated group was 3.01 (95% CI 1.45-6.23) and of developing ulcerative colitis was 2.53 (1.15-5.58). There was no significant difference between these two groups in coeliac disease prevalence. Increased prevalence of inflammatory bowel disease, but not coeliac disease or peptic ulceration, was found in the vaccinated cohort compared with their partners. These findings suggest that measles virus may play a part in the development not only of Crohn's disease but also of ulcerative colitis.

摘要

麻疹病毒可能在肠道组织中持续存在,尤其是受克罗恩病影响的肠道组织,早期接触麻疹可能是克罗恩病发病的一个危险因素。克罗恩病和溃疡性结肠炎在同一家族中出现,可能有共同的病因。鉴于炎症性肠病(克罗恩病和溃疡性结肠炎)的发病率不断上升,我们研究了麻疹疫苗接种对这些疾病的影响。在1964年作为麻疹疫苗试验一部分接种过麻疹活疫苗的3545人中,确定了克罗恩病、溃疡性结肠炎、乳糜泻和消化性溃疡的患病率。一个由11407名受试者组成的纵向出生队列作为一个未接种疫苗的对照队列,另外2541名接种疫苗者的配偶作为另一个对照队列。与出生队列相比,接种疫苗组患克罗恩病的相对风险为3.01(95%可信区间1.45 - 6.23),患溃疡性结肠炎的相对风险为2.53(1.15 - 5.58)。这两组在乳糜泻患病率上没有显著差异。与他们的配偶相比,接种疫苗队列中炎症性肠病的患病率增加,但乳糜泻或消化性溃疡的患病率没有增加。这些发现表明,麻疹病毒可能不仅在克罗恩病的发病中起作用,而且在溃疡性结肠炎的发病中也起作用。

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