我国先天性心脏病患儿预防接种现状研究的系统综述

Systematic review of current research on vaccination of congenital heart disease children in China

【目的】先天性心脏病(CHD)是儿童常见的出生缺陷,发病率有逐年上升趋势。作为特殊健康状态儿童,其预防接种情况成为关注重点。本文对我国CHD患儿预防接种现状研究进行系统综述,以了解CHD患儿预防接种工作中存在的问题,为提高CHD患儿疫苗接种率、减少疫苗可预防疾病的发病提供指导依据,并为后续研究方向提供思路。【方法】在中国知网、万方数据知识服务平台、维普网、中国生物医学和Web of Science、PubMed、EmBase、the Cochrane Library等中英文数据库中检索有关我国CHD患儿预防接种研究的文献,检索时限为建库至2023年3月。根据纳入和排除标准确定相关文献,进行数据提取、总结归纳研究结果。【结果】最终纳入15篇文献。3篇针对我国CHD患儿预防接种的专家共识(指南建议)均认为CHD患儿预防接种可行且必要。系统分析发现CHD患儿疫苗及时接种率总体在34%~50%,延迟接种现象明显。但经专业评估门诊评估后,绝大多数CHD患儿被建议按照国家推荐的时间表接种,仅2%左右患儿被要求暂缓/推迟接种。CHD患儿接种后报告疑似预防接种异常反应(AEFI)发生比例较低,与正常/对照儿童没有显著性差异。【结论】我国CHD患儿预防接种的安全性较好,但疫苗及时接种率较低,建议相关部门能够给予一定的预防接种政策支持,以提高CHD患儿预防接种的普及率和及时率。CHD患儿预防接种有效性的研究匮乏,亟需开展相关研究,以进一步完善我国CHD患儿疫苗接种策略。

[Objective]Congenital heart disease(CHD)is a common birth defect in children,with its incidence increasing annually.Because of their special health status,the vaccination situation for children with CHD has become a focal point of attention.This paper systematically reviews the current status of vaccination among children with CHD in China to identify existing issues in vaccination efforts for children with CHD,provide guidance for increasing vaccination rates among children with CHD,reduce the incidence of vaccine-preventable diseases,and provide ideas for subsequent research.[Methods]Literature on the vaccination of children with CHD in China was searched in both Chinese and English databases,including CNKI,Wanfang Data Knowledge Service Platform,VIP,Chinese Biomedical and Web of Science,PubMed,EmBase,and the Cochrane Library.Relevant literature was identified based on inclusion and exclusion criteria,and data extraction was carried out to summarize the research results.[Results]A total of 15 studies were included.Three articles focusing on expert consensus(guideline recommendations)for vaccination of children with CHD in China all agreed that vaccination is both feasible and necessary for children with CHD.Systematic analysis found that the overall timely vaccination rate for children with CHD was between 34%and 50%,with a notable delay in vaccination.However,after professional outpatient assessment,the vast majority of children with CHD were advised to be vaccinated according to the national recommended schedule,with only about 2%of them being advised to delay vaccination.The proportion of children with CHD who reported suspected adverse events following immunization(AEFI)was low and not significantly different from that of healthy/control children.[Conclusion]The safety of vaccinations for children with CHD in China is relatively high,but the total timely vaccination rate is currently low.In order to improve the coverage and timeliness of vaccination in children with CHD,it is recommended that relevant departments provide vaccination policy support.There is a lack of research on the effectiveness of vaccination in children with CHD,so further studies are urgently needed to further improve the vaccination strategy for children with CHD in China.