在患有输血依赖性沙拉西米亚的儿童中重新考虑乙型肝炎疫苗接种
Angga Wirahmadi1, Ludi Dhyani Rahmartani2, Pustika Amalia Wahidiyat2
1Faculty of Medicine, Department of Pediatrics, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. angga.wirahmadi01@ui.ac.id.
尽管接种了疫苗,但thalassemia儿童往往缺乏乙型肝炎病毒 (HBV) 保护. 增强剂量提高了75%的免疫力,而年龄和脊髓切除术影响了反应,这表明有针对性的疫苗接种策略.
科学领域:
- 儿科 儿科 儿科
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
背景情况:
- thalassemia是一种在thalassemia带中普遍存在的遗传性血液疾病.
- 患有thalassemia的儿童需要经常输血,增加乙型肝炎病毒 (HBV) 感染的风险.
- 血症中的免疫调节障碍可能会损害对HBV疫苗接种的长期保护.
研究的目的:
- 为了评估额外的乙型肝炎疫苗在患有血症的儿童的疗效.
- 确定影响该群体对乙型肝炎疫苗接种免疫反应的因素.
主要方法:
- 在雅加达检查了126名儿科沙血病患者 (3-18岁).
- 72名HBV免疫力不足的参与者接受了一次单次乙型肝炎疫苗强剂.
- 免疫反应 (抗HBs标位) 在增强剂后一个月被评估;逻辑回归确定了预测因素.
主要成果:
- 继增剂后,75%的人获得了保护性免疫力,其中50%的人表现出高标位.
- 年龄 (OR=0.5) 和脊髓切除术是后增剂抗HBs水平的显著预测因素.
- 分析了诸如性别,沙拉西米亚类型,输血间隔,费里丁和营养状况等因素.
结论:
- 乙型肝炎疫苗的增强剂可以增强患有血病的儿童的保护性免疫力.
- 对于3岁以上的依赖输血的沙拉西米亚儿童,建议给予增强剂量.
- 年龄和脊髓切除术状况是影响这一群体接种疫苗的关键因素.
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