慢性肾脏病及透析患儿的疫苗接种

Immunization in children with chronic renal diseases and undergoing dialysis

慢性肾脏病患儿大多存在免疫紊乱及免疫功能缺陷。各种病原菌的感染率明显增高，尤其容易感染肺炎链球菌、HBV及流感病毒。在全球范围内，肺炎链球菌是细菌性肺炎和中耳炎的最常见病原，是细菌性脑膜炎的主要病原菌。血液透析的患儿更是HBV易感染的高危人群。流感是具有高度传染性及极其广泛的传播性疾病。美国免疫实践指南咨询委员会（ACIP）及改善全球肾脏病预后（KDIGO）特别推荐慢性。肾脏病及慢性透析的患者接种的3种疫苗是HBV疫苗、灭活流感病毒疫苗及肺炎链球菌疫苗。接种疫苗是特异性的预防措施，可对慢性肾脏病及透析患者提供有效的预防保护。

Most children patients with chronic kidney disease show immune disorders and defects of immune functionality. There are significant increases in various pathogen infections, especially streptococcus pneumonia, hepatitis B virus, and influenza virus. Streptococcus pneumonia is the most common cause of bacterial pneumonia and otitis media worldwide, and the main pathogens of bacterial meningitis as well. Children treated by hemodialysis are in high risk cir- cumstance susceptible to hepatitis B virus. Influenza is a highly contagious disease with extremely strong dissemination capability. The organizations of U. S. Advisory Committee on Immunization Practices（ACIP） , and Kidney Disease： Improving Global Outcomes （KDIGO） specifically recommends 3 vaccines, namely, hepatitis B virus, influenza virus （ inactivated）, and pneumococcal vaccine for patients with chronic kidney disease and chronic dialysis. Vaccination is a specific preventive and an effective protective measure for patients of chronic kidney disease and undergoing dialysis.