Takamatsu I, Kameda M, Inoue T, Toyoshima K
Division of Pediatrics, Osaka Prefectural Habikino Hospital, Japan.
Kekkaku. 1995 Sep;70(9):561-6.
We performed a retrospective analysis of the history of BCG vaccination of 367 childhood patients who were treated for active tuberculosis (TB) in our hospital from 1976 to 1994. Fifty-eight percent of 367 cases, 83.1% of cases under 5 years of age and 92% of tuberculous meningitis had not received BCG. To investigate the effectiveness of BCG vaccination against TB, we carried out case-control studies using 59 patients with TB and 118 controls without TB. The cases were patients treated for TB in our hospital from 1988 through Nov. 1994. Two controls were chosen for every case with matching for sex, age at admission, year of admission and place of residence. Based on whole 59 pairs, BCG vaccination was shown to have protective efficacy of 78% (95% confidence interval [CI], 57-89%). For 34 pairs of under 5 years of age, estimated efficacy was 92% (95%CI, 80-97%), for primary pulmonary disease (27 pairs) it was 92% (95%CI, 78-97%). For bacteriologically confirmed TB (27 pairs), it was 84% (95%CI, 58-94%), while for bacterilogically negative TB (32 pairs) 71% (95%CI, 27-89%). Our results indicate that BCG vaccination with multipuncture methold protected considerably against TB in infants including primary pulmonary TB.
我们对1976年至1994年在我院接受活动性肺结核(TB)治疗的367例儿童患者的卡介苗接种史进行了回顾性分析。367例病例中,58%、5岁以下病例的83.1%以及结核性脑膜炎病例的92%未接种卡介苗。为了研究卡介苗接种对结核病的有效性,我们对59例结核病患者和118例无结核病对照进行了病例对照研究。病例为1988年至1994年11月在我院接受结核病治疗的患者。每例病例选择两名对照,按性别、入院年龄、入院年份和居住地进行匹配。基于全部59对数据,卡介苗接种显示具有78%的保护效力(95%置信区间[CI],57 - 89%)。对于34对5岁以下的病例,估计效力为92%(95%CI,80 - 97%),对于原发性肺结核(27对)为92%(95%CI,78 - 97%)。对于细菌学确诊的结核病(27对),为84%(95%CI,58 - 94%),而对于细菌学阴性的结核病(32对)为71%(95%CI,27 - 89%)。我们的结果表明,采用多点注射法接种卡介苗对包括原发性肺结核在内的婴儿结核病有相当大程度的保护作用。