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輔仁醫學期刊

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篇名 Tuberculin Response in Infants Six Months after an Intradermal Bacille Calmette-Guérin Vaccination
卷期 5:3
並列篇名 初生兒接種卡介苗預防注射六個月後之皮膚結核菌素反應
作者 沈仲敏宋文舉鄭枚枝黃碧桃
頁次 115-121
關鍵字 結核病卡介苗預防注射皮膚結核菌素測驗BCG vaccineTuberculin testTuberculosis
出刊日期 200709

中文摘要

初生兒施行卡介苗疫苗預防注射,在台灣施行已久,由於近來結核病的死灰復燃,便以此篇研究評估卡介苗預防注射在台灣的有效性及注射後之皮膚反應。本研究收集自2001 年5 月至2001 年10 月中在本院出生之健康新生兒,由家長填寫同意書後接受CBC、DC及CXR之檢查,並於出生48 小時內注射卡介苗,個案須於出生第1、第4、第8、第12 及第24 週返診,返診時由專人做身體理學檢查並紀錄注射處皮膚的變化,此外第24 週返診時需重複檢查CBC、DC、CXR,及接受皮膚結核菌素測驗,並在48至72 小時後檢查反應。結果共收集了150 個個案,其中109 人完成實驗,皮膚結核菌素測驗呈陽性者佔68.2%,其中有一人注射處皮膚完全沒有反應但皮膚結核菌素測驗卻呈陽性。皮膚結核菌素測驗轉陽性和注射處是否形成疤痕組織沒有相關性,卻和注射處是否曾化膿有相關。因此以是否有疤痕組織之形成來研判卡介苗預防注射之有效性並不準確,但能否以注射處是否曾化膿來評估尚需要更多之研究來證實。

英文摘要

Background and Purpose: We evaluated the effectiveness of a bacille Calmette-Gu rin(BCG) vaccination in terminfants by looking at the following criteria: (1) the percentage of infantswith scarring; (2) the percentage of infants experiencing tuberculin conversion 6 months after thevaccination; and (3) the number of complications fromthe vaccination.Materials andMethods:FromMay to October 2001, healthy full-term infants born at our hospital whose parents providedinformed consent were enrolled. They received a BCG vaccination within 48 h of birth, and thevaccination site was examinedwhen the infantswere 1, 4, 8, 12, and 24weeks old. They were givena purified protein derivative (PPD) skin test at 6 months old, and the reaction was checked 48~72h later. Results: In total, 150 term infants were enrolled, among which 109 infants completed thecourse. The PPD test was positive (induration 5 mm) in 75 (68.2%) of the infants.One infant hadno visible BCG vaccination lesion, but the PPD skin test was positive. There was no correlationbetween the rate of scarring and tuberculin conversion in these infants. There was a significantcorrelation between sterile abscess formation and tuberculin conversion. Conclusions:Although the tuberculin response after the BCG vaccination could not be predicted by scarformation, it was correlated with abscess formation.

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