中国防痨杂志 ›› 2020, Vol. 42 ›› Issue (10): 1128-1133.doi: 10.3969/j.issn.1000-6621.2020.10.020
收稿日期:
2020-05-14
出版日期:
2020-10-10
发布日期:
2020-10-15
通信作者:
何秋水
E-mail:qiuhe@utu.fi
基金资助:
CHEN Ning, SUN Lin, SHEN A-dong, HE Qiu-shui*()
Received:
2020-05-14
Online:
2020-10-10
Published:
2020-10-15
Contact:
HE Qiu-shui
E-mail:qiuhe@utu.fi
摘要:
卡介苗除了用来预防结核病以外,也可以诱导非特异性保护作用。流行病学调查结果显示,卡介苗对其他病原体感染有一定的保护作用,可以有效提高儿童的存活率,并且有些已经通过随机临床试验得到验证。作者将对相关流行病学的研究结果和这种现象形成的机制进行总结。
陈柠, 孙琳, 申阿东, 何秋水. 卡介苗非特异性保护作用研究进展[J]. 中国防痨杂志, 2020, 42(10): 1128-1133. doi: 10.3969/j.issn.1000-6621.2020.10.020
CHEN Ning, SUN Lin, SHEN A-dong, HE Qiu-shui. Research progress on the non-specific protective effect of BCG[J]. Chinese Journal of Antituberculosis, 2020, 42(10): 1128-1133. doi: 10.3969/j.issn.1000-6621.2020.10.020
表1
卡介苗对麻风病非特异性保护的相关研究
第一作者/参考文献 | 发表年份 | 研究类型 | 区域 | 人群 | 麻风病患者 例数 | 卡介苗对麻风病 保护效果 |
---|---|---|---|---|---|---|
Stanley[ | 1981 | 试验研究 | 乌干达 | 儿童 | 269 | 保护率为80% (95%CI:72%~86%) |
Lwin[ | 1985 | 试验研究 | 缅甸 | 儿童 | 663 | 保护率为20.4% (95%CI:12%~28%) |
Bagshawe[ | 1989 | 试验研究 | 新几内亚岛 | 各年龄段 | 281 | 保护率为48% (95%CI:34%~59%) |
P?nnighaus[ | 1992 | 试验研究 | 马拉维 | 各年龄段 | 414 | 保护率为50% |
Rodrigues[ | 1992 | 病例对照研究 | 巴西 | <16岁 | 62 | 保护率为81% |
Baker[ | 1993 | 病例对照研究 | 马拉维 | 平均(22.1±6.0)岁 | 145 | 保护率为63.6% (95%CI:42.2%~77.2%) |
Karonga Prevention Trial Group[ | 1996 | 试验研究 | 马拉维 | 各年龄段 | 93 | 相对危险度为0.51 (95%CI:0.25~1.03) |
Lombardi[ | 1996 | 病例对照研究 | 巴西 | <16岁 | 78 | 保护率为90% (95%CI:78%~96%) |
Bertolli[ | 1997 | 病例对照研究 | 缅甸 | 6~24岁 | 351 | 保护率为66% (95%CI:44%~80%) |
Zodpey[ | 1998 | 病例对照研究 | 印度 | <32岁 | 314 | 比值比为0.29 (95%CI:0.21~0.41) |
Zodpey[ | 1999 | 病例对照研究 | 印度 | <35岁 | 212 | 比值比为0.40 (95%CI:0.23~0.68) |
Cunha[ | 2004 | 队列研究 | 巴西 | 7~14岁 | 181 | 保护率为74% (95%CI:57%~86%) |
Zodpey[ | 2005 | 病例对照研究 | 印度 | 各年龄段 | 364 | 比值比为0.46 (95%CI:0.34~0.61) |
Rahete[ | 2007 | 病例对照研究 | 印度 | 成年人 | 201 | 比值比为0.65 (95%CI:0.40~1.04) |
Zodpey[ | 2007 | 病例对照研究 | 印度 | 成年人 | 292 | 比值比为0.38 (95%CI:0.26~0.55) |
Düppre[ | 2008 | 队列研究 | 巴西 | 各年龄段 | 1161 | 保护率为56% (95%CI:31%~71%) |
表2
卡介苗对病毒非特异性保护的相关研究
第一作者/参考文献 | 发表年份 | 病毒 | 研究类型 | 国籍 | 患者例数 | 主要发现 |
---|---|---|---|---|---|---|
Stensballe[ | 2005 | 呼吸道合胞病毒 | 病例对照研究 | 几内亚、 巴西 | 386 | 呼吸道合胞病毒患儿中未接种卡介苗的占比高于对照组(11.0% vs 5.8%),但差异无统计学意义 |
Arts[ | 2018 | 黄热病毒 | 随机临床试验 | - | 30 | 接种卡介苗可以降低黄热病毒疫苗接种后的病毒血症 |
Hippmann[ | 1992 | 单纯疱疹病毒 | 试验研究 | - | 109 | 全部单纯疱疹病毒患者接种卡介苗后4~6个月内未出现疱疹 |
Podder[ | 2017 | 人乳头瘤病毒 | 随机临床试验 | 印度 | 60 | 接种卡介苗能够明显减少疣的数量,卡介苗组疣完全清除的比例优于结核菌素纯蛋白衍生物组 |
Leentjens[ | 2015 | 流感病毒 | 随机临床试验 | - | 40 | 在接种流感病毒疫苗前接种卡介苗能够明显促进H1N1流感病毒功能性抗体的产生 |
Daulatabad[ | 2016 | 人乳头瘤病毒 | 病例系列报告 | - | 7 | 7例患者中,接种卡介苗后疣减少的例数为6例,其中完全清除的例数为2例。但4例患者发生不良反应,包括接种部位肿胀、淋巴结肿大等 |
Salem[ | 2013 | 人乳头瘤病毒 | 随机临床试验 | - | 80 | 与安慰剂组相比,局部接种卡介苗能够明显提高对疣的清除效果(P<0.001) |
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