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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (6): 532-538.doi: 10.3969/j.issn.1000-6621.2021.06.002

• 指南·规范·共识 • 上一篇    下一篇

卡介苗不良反应临床处理指南

  

  1. 中华医学会结核病学分会 中国防痨协会学校与儿童结核病防治专业分会
  • 收稿日期:2021-04-26 出版日期:2021-06-10 发布日期:2021-06-02
  • 基金资助:
    “十三五”国家科技重大专项(2018ZX10731301);上海市临床重点专科建设项目(shslczdzk03002);国家自然科学基金(81770011);国家自然科学基金(81900005)

Guideline for clinical management of adverse reactions of bacillus Calmette-Guérin

  

  1. Tuberculosis Branch of Chinese Medical Association, School and Children Tuberculosis Branch of Chinese Antituberculosis Association.
  • Received:2021-04-26 Online:2021-06-10 Published:2021-06-02

摘要:

卡介苗(bacillus Calmette-Guérin,BCG)是一种预防结核病的减毒活疫苗,是至今全球接种最广泛、最安全的疫苗之一。中国自1978年开始广泛接种BCG后,儿童粟粒性结核病及结核性脑膜炎的发病率和死亡率显著降低。除了应用于预防结核病外,BCG也常用于膀胱原位癌灌注治疗,采用BCG灌注可以降低和延缓非肌层浸润性膀胱癌的复发和进展,是目前公认效果最佳的膀胱灌注药品。但是由于生产工艺、疫苗毒力强弱、疫苗使用方法及个体差异等因素,BCG接种及灌注后的不良反应也时有发生。目前,BCG不良反应的临床处理尚未统一和规范。为此,中华医学会结核病学分会联合中国防痨协会学校与儿童结核病防治专业分会,组织专家进行深入讨论,制定了《卡介苗不良反应临床处理指南》。本指南介绍了BCG种类、使用方法,以及BCG不良反应的表现、诊断、治疗及预防等,以期医护人员用于规范处理BCG不良反应。

关键词: 卡介苗, 药物毒性, 治疗应用, 指南

Abstract:

Bacillus Calmette-Guérin (BCG) is a live attenuated vaccine against tuberculosis, and is one of the most widely used and safest vaccines in the world. The prevalence and mortality of miliary tuberculosis and tuberculous meningitis in children have significantly decreased since being vaccinated with BCG from 1978 in China. BCG is applicated in the prevention of tuberculosis, in addition, it is also commonly used in perfusion therapy for bladder carcinoma in situ. BCG instillation helps to reduce and delay the recurrence and progression of non-muscle invasive bladder carcinoma, it is considered as the best intravesical instillation drug at present. However, due to the production process, the virulence of the vaccine, the methods of usage of the vaccine, individual differences and other factors, the adverse reactions after BCG vaccination and perfusion often occur. The clinical treatment of BCG adverse reactions has not been standardized by now. Therefore, the Tuberculosis Branch of Chinese Medical Association, the School and Children Tuberculosis Branch of Chinese Antituberculosis Association organized some experts to formulated the “Guideline for Clinical Treatment of BCG Adverse Reactions” after discussions. The guideline includes the types of BCG, the methods of usage, and clinical characteristics, diagnostic criteria, treatment and prevention of the adverse reactions of BCG vaccine, in order to standardize with the treatment for the adverse reactions of BCG.

Key words: BCG vaccine, Drug toxicity, Therapeutic uses, Guidebooks