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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases.
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Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases.

机译：含硫柳汞的疫苗的安全性：计算机化的健康维护组织数据库的两阶段研究。

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OBJECTIVE: To assess the possible toxicity of thimerosal-containing vaccines (TCVs) among infants. METHODS: A 2-phased retrospective cohort study was conducted using computerized health maintenance organization (HMO) databases. Phase I screened for associations between neurodevelopmental disorders and thimerosal exposure among 124 170 infants who were born during 1992 to 1999 at 2 HMOs (A and B). In phase II, the most common disorders associated with exposure in phase I were reevaluated among 16 717 children who were born during 1991 to 1997 in another HMO (C). Relative risks for neurodevelopmental disorders were calculated per increase of 12.5 micro g of estimated cumulative mercury exposure from TCVs in the first, third, and seventh months of life. RESULTS: In phase I at HMO A, cumulative exposure at 3 months resulted in a significant positive association with tics (relative risk [RR]: 1.89; 95% confidence interval [CI]: 1.05-3.38). At HMO B, increased risks of language delay were found for cumulative exposure at 3 months (RR: 1.13; 95% CI: 1.01-1.27) and 7 months (RR: 1.07; 95% CI: 1.01-1.13). In phase II at HMO C, no significant associations were found. In no analyses were significant increased risks found for autism or attention-deficit disorder. CONCLUSIONS: No consistent significant associations were found between TCVs and neurodevelopmental outcomes. Conflicting results were found at different HMOs for certain outcomes. For resolving the conflicting findings, studies with uniform neurodevelopmental assessments of children with a range of cumulative thimerosal exposures are needed.
机译：目的：评估含硫柳汞的疫苗（TCV）对婴儿的可能毒性。方法：使用计算机化的健康维护组织（HMO）数据库进行了两阶段的回顾性队列研究。第一阶段筛查了1992年至1999年在2个HMO（A和B）出生的124170例婴儿的神经发育障碍和硫柳汞暴露之间的关联。在第二阶段，对1991年至1997年在另一HMO（C）中出生的16 717名儿童中与第一阶段暴露相关的最常见疾病进行了重新评估。在生命的第一，第三和第七个月，TCV估计累积汞暴露量每增加12.5微克，就会计算出神经发育障碍的相对风险。结果：在HMO A的第一阶段中，三个月的累积暴露导致与抽动相关的显着正相关（相对风险[RR]：1.89; 95％置信区间[CI]：1.05-3.38）。在HMO B，发现在3个月（RR：1.13; 95％CI：1.01-1.27）和7个月（RR：1.07; 95％CI：1.01-1.13）的累积暴露会增加语言延迟的风险。在HMO C的第二阶段，未发现明显的关联。在任何分析中，没有发现自闭症或注意力缺陷障碍的风险显着增加。结论：TCV与神经发育结局之间未发现一致的显着关联。在某些特定结果的不同HMO上发现了相互矛盾的结果。为了解决矛盾的发现，需要对具有一系列累积硫柳汞暴露量的儿童进行统一的神经发育评估的研究。

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