后疫情时代下特发性肾病综合征患儿免疫接种的再思考

Concerns for immunization of children with idiopathic nephrotic syndrome in the post-epidemic era

感染是特发性肾病综合征患儿较为常见的危重并发症之一。尽管疫苗接种作为预防继发感染的有效措施,但其仍然面临诸多问题。一方面,患儿自身的免疫状态(自身免疫系统紊乱、使用免疫抑制剂等)增加了疫苗接种后免疫系统是否能产生足够保护性抗体的不确定性。另一方面,疫苗潜在的致病风险(肾病复发及诱发疫苗相关疾病)需要在患儿接种时进行综合评估。在后"新型冠状病毒肺炎(COVID-19)"疫情时代下,现拟对儿童肾病综合征预防接种的安全性、有效性及时机等进行总结,并在此基础上探讨接种新型冠状病毒(SARS-CoV-2)疫苗可能面临的问题。

Infection is one of the most familiar complications in children with idiopathic nephrotic syndrome.Although vaccination is an effectual measure in prevention of secondary infections,it still faces many problems.On the one hand,children′s own immune status(immune system dysfunction,administration with immunosuppressants,etc.)lends additional uncertainties to whether the immune system can produce sufficient protective antibodies after vaccination.On the other hand,potential risks(recurrence of nephrotic syndrome and induction of vaccine related diseases)need to be comprehensively assessed at the time of vaccination.In this paper,the safety,effectiveness and timing of va-ccination in children with nephrotic syndrome in the post-COVID-19 period were summarized,and possible problems of vaccination against severe acute respiratory syndrome Coronavirus 2(SARS-CoV-2)were discussed.