卡介苗与儿童原发性免疫缺陷病

Bacille Calmette-Guérin and primary immunodeficiency in Children

卡介苗是来源于牛结核分枝杆菌的经多次传代培养的毒力减弱的活疫苗,可预防儿童结核的严重形式如粟粒性肺结核和结核性脑膜炎。几种儿童原发性免疫缺陷病对卡介苗疫苗株敏感。该文介绍重症联合免疫缺陷病、慢性肉芽肿病、呈孟德尔遗传的分枝杆菌病的发病率、发病机制、临床表现,尤其重点介绍与卡介苗相关的疾病特点、治疗原则及预后。探讨该类脆弱儿童避免接种卡介苗的可能策略。

Bacillus-Calmette Guérin(BCG)vaccine is a live attenuated strain of Mycobacterium bovis(M.bovis)subsp.Intradermal BCG vaccination can prevent severe types of tuberculosis in children such as milliary tuberculosis of lung or tuberculous meningitis.Children with several primary immunodeficiencies are susceptible to BCG vaccines.The prevalence,pathogenesis,clinical manifestations for severe combined immunodeficiency,chronic granulomatous disease,and Mendelian susceptibility to mycobacterial disease will be reviewed.More attention will be paid on features,treatment,and prognosis of BCG diseases in children with such primary immunodeficiencies mentioned above.