儿童疫苗接种和热性惊厥相关性研究进展

Research progress on the correlation between childhood vaccination and febrile convulsion

目前我国儿童预防接种疫苗已全面普及,而疫苗接种不良反应也不断出现,受到社会普遍关注。疫苗让人体产生免疫力的同时,极小部分可引起人体不良反应,例如发热、局部红肿硬结、过敏性水肿、休克及喉头水肿等。发热是最常见的不良反应,大部分儿童对于疫苗引起的发热可以耐受,然而小部分儿童接种疫苗后可能会出现热性惊厥这类严重的不良反应。热性惊厥(febrile seizures,FS)好发于年龄为3个月~6岁的儿童,此时期是儿童接种疫苗的主要时期。热性惊厥是影响国内外儿童预防接种普及的重要原因之一。现研究认为热性惊厥主要由遗传、环境等多因素引起,且部分研究认为热性惊厥的发生与体内细胞因子水平的变化有关。疫苗接种可引起体内细胞因子水平变化,如白细胞介素-1、白细胞介素-6等,且不同疫苗导致的细胞因子水平变化情况可能不一样。疫苗接种后导致发热,可能引起部分热敏感相关的癫痫综合征的发作,例如Dravet综合征。本文通过免疫和遗传因素2个方面对儿童疫苗接种与热性惊厥的相关性进行综述,从而正确认识疫苗接种对儿童热性惊厥发生的影响,为惊厥儿童的预防接种提供一些建议与指导。

At present,Children's vaccination has been fully popularized in China,and the adverse reaction of vaccination has been constantly appearing,which has been widely concerned by the society.While vaccines provide immunity,very few of them can cause adverse reactions,such as fever,local redness and induration,anaphylactic edema,shock and laryngeal edema.Fever is the most common adverse event,and most children can tolerate vaccine-induced fever,although a small proportion will experience severe adverse events such as febrile convulsion.Febrile seizures(FS)occur in children aged from 3 months to 6 years,which are the main periods of childhood vaccinations.FS was one of the most important factors influencing the popularity of childhood vaccination in China and abroad.Now,studies suggest that FS is mainly caused by multiple factors such as genetics and environmental,and some studies suggest that the occurrence of FS is related to the changes of cytokines in vivo.Vaccine can cause changes of cytokine levels,such as IL-1,IL-6,etc.,and the changes of cytokine levels may be different with different vaccines.Fever following vaccination may lead to the onset of some heat-sensitive epileptic syndromes,such as Dravet syndrome.In this paper,the correlation between children's vaccination and febrile convulsion was reviewed from two aspects of immune and genetic factors,so as to correctly understand the influence of vaccination on the occurrence of febrile convulsion in children,and provide some suggestions and guidance for the preventive inoculation of children with convulsion.