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目的:评价早产儿的白喉-破伤风-非细胞性的百日咳-未激活的脊髓灰质炎-流感嗜血杆菌B型(DtaP-IPV-HIB)免疫的安全性。研究设计:我们对78 例极低体重早产儿(平均胎龄28±2周;平均出生体重1045±357 g)进行了观察性研究。在他们出院前给予DtaP-IPV-HIB疫苗注射。在接种疫苗前后,分别对呼吸暂停、心动过缓、需要吸氧和氧饱和度、喂养练习及医学干预等指标进行评估。根据临床情况的严重程度和早产症状的持续情况对评估的结果进行分析。结果:使用DtaP-IPV-HIB后有47%的婴儿诱发或加重了心肺症状(15%出现呼吸暂停,21%出现心动过缓,42%出现低氧血症)。大部分由接种疫苗引起的症状自然减轻或者在短暂的刺激后减轻。接种时,相对危险性在有严重临床症状或持续心肺症状的婴儿中高出5-8倍。78例婴儿中有5例接受了面罩呼吸支持,在有慢性肺病的21例婴儿中有4例出现短暂的吸氧量增加,所有患儿均不需要再次通气。亦不需要再次吸氧、终止积极的经口喂养或推迟出院。结论:心肺症状在DTaP-IPV-
PURPOSE: To evaluate the safety of diphtheria-tetanus-acellular pertussis-non-activated polio-Haemophilus influenzae type B (DtaP-IPV-HIB) immunization in preterm infants. Study Design: We performed an observational study of 78 very low birth weight preterm infants (mean gestational age 28 ± 2 weeks; mean birth weight 1045 ± 357 g). The DtaP-IPV-HIB vaccine was given before they were discharged from the hospital. Before and after vaccination, apnea, bradycardia, oxygen and oxygen saturation, feeding practices and medical interventions were evaluated separately. The results of the assessment were analyzed based on the severity of the clinical condition and the persistence of symptoms of preterm birth. RESULTS: Cardiovascular symptoms were induced or worsened in 47% of infants after DtaP-IPV-HIB (15% apnea, 21% bradycardia and 42% hypoxemia). Most of the symptoms caused by vaccination are naturally relieved or alleviate after a brief stimulation. At vaccination, the relative risk is 5-8 times higher in infants with severe clinical symptoms or persistent cardiorespiratory symptoms. Five of the 78 infants received face mask respiratory support, and four of 21 infants with chronic lung disease experienced a transient increase in oxygen uptake and none of the infants required re-aeration. There is also no need to re-oxygen, stop active oral feeding or postpone discharge. Conclusion: Cardiopulmonary symptoms in DTaP-IPV-