轮状病毒疫苗相关肠套叠风险的回顾性分析

Retrospective analysis on risk of rotavirus vaccine associated intussusception

接种轮状病毒疫苗是控制轮状病毒传播、降低婴幼儿重症腹泻住院、死亡的最佳手段。早期人们过于关注疫苗可能增加肠套叠发生风险而忽略了疫苗本身降低疾病死亡率的重要意义,随着医疗技术及认知水平的提高,对轮状病毒疫苗的评价也趋于理性。本文对多个已上市轮状病毒疫苗与肠套叠发生的相关性进行了总结,并对其发生的机制进行了探讨,发现几乎所有轮状病毒疫苗均可增加肠套叠发生的风险,但出于对轮状病毒疫苗接种所带来的综合效益要远高于肠套叠风险的考虑,此风险已被多个国家监管机构接受。

Rotavirus vaccine is the most effective method to control the transmission of rotavirus and decrease the hospitalization and fatality cases caused by serious diarrhea among infants. In the past, people paid more attention to the potential risks associated with rotavirus vaccine but neglected the significance of the vaccine in preventing rotavirus-associated illness. However, with the development of medical technology and increasing knowledge on vaccine, the assessment on rotavirus vaccine is more rational than ever before. This paper evaluates the association of several marketed rotavirus vaccines with intussusception, and discusses the mechanism of onset of intussusceptions. It is found that all the rotavirus vaccines may increase the risk of intussusception. However, for the sake of the comprehensive benefits of rotavirus vaccine far outweigh the risk of intussusception, the risk is already accepted by many national regulatory agencies.