葡萄糖皮质体剂量和疫苗接种的影响:全球定义的演变
Xia Wang1, Cyra Patel1,2, Michelle L Giles3,4
1National Centre for Immunisation Research and Surveillance, Westmead, New South Wales.
概括
高剂量的葡萄皮质激素降低了疫苗反应,而低剂量的类固醇维持了它. 个体风险益处评估对于接受葡萄皮质类药物治疗的患者的免疫非常重要,而不是严格的剂量值.
科学领域:
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
- 疫苗学 疫苗学 疫苗学
背景情况:
- 国际免疫准则经常在没有明确的理由的情况下定义"高剂量"葡萄皮质体 (例如,每天超过20毫克的普雷尼索因相当量).
- 了解不同剂量的葡萄糖皮质激素对疫苗有效性和安全性的影响,对于患者护理至关重要.
研究的目的:
- 审查关于葡萄糖皮质醇剂量与疫苗反应之间的关系的现有证据.
- 评估在接受葡萄糖皮质醇治疗的患者接种疫苗的安全性和有效性.
主要方法:
- 通过学术数据库搜索进行了文献叙事审查.
- 确定和合成了有关葡萄糖皮质激素剂量,疫苗反应和安全性的证据.
主要成果:
- 在接受低剂量普得尼松 (<7毫克/天) 的人群中,疫苗反应保持不变.
- 高剂量葡萄糖皮质类药物 (>20 mg/天) 与降低抗体标位和血清阳性有关.
- 关于低至中剂量的皮质糖类 (7-20毫克/天) 和它们对疫苗疗效的影响的数据是不确定的.
- 由于剂量不一致,目前没有足够的数据来确定统一的儿科高剂量葡萄皮质激素值.
结论:
- 临床医生应优先考虑个人风险和益处的评估,而不是在接受葡萄糖皮质醇治疗的患者中严格的免疫剂量门.
- 非活体疫苗通常耐受性很好,但活体疫苗可能会对严重免疫受损的个体构成风险.
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