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İDİOPATİK NEFROTİK SENDROMLU ÇOCUKLARDA PNÖMOKOK AŞISININ ENFEKSİYON VE RÖLAPSLARA ETKİSİ

EFFECTS OF PNEUMOCOCCAL VACCINE ON INFECTIONS AND RELAPSES IN CHILDREN WITH NEPHROTIC SYNDROME

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Abstract (2. Language): 
Eighteen steroid-responsive children with nephrotic syndrome were vaccinated with pneumococcal vaccine (PNEUMO-23) in order to investigate the effectiveness and necessity of this vaccine and they were followed up for three years. Twenty steroid-responsive children with nephrotic syndrome were also followed up for the same period without vaccination as a control group. Relaps rate in the study group after vaccination was 1 / 19.1 patient months, while it was 1/16 patient months in the control group, and a significant difference was found between them (p < 0.05). Infection rate oj relapses was also significantly lower in the study group (62.5 %) than the control group (55.5 %) (p < 0.01). Thirteen patients whose follow-up period was more than one year before vaccination showed a significant decrease in relaps rate after vaccination which was found to be 1 / 13.3 ± 1 / 57.14 patient months (p < 0.01). Infection rates of relapses in the study group also decreased after vaccination (p < 0.001). This study showed that pneumococcal vaccination decreased the frequency of relapses and infection rate in children with nephrotic syndrome and it is concluded that routine vaccination of these patients would be of benefit.
Abstract (Original Language): 
tdiopatik nefrotik sendromlu çocuklarda pnömokok aşısının etkinliğini ve bu hastaların takip ve tedavisinde rutin olarak kullanılmasının gerekliliğini araştırmak üzere 18 steroide cevaplı nefrotik sendromlu çocuğa saflaştırılmış pnömokok aşısı (PNEUMO-23) yapıldı ve aşı sonrası 3 yıl izlendi. Kontrol grubu olarak alınan 20 steroide cevaplı nefrotik sendromlu çocuk ise aynı süre içinde aşı yapılmadan izlendi. Çalışma grubunda aşı sonrası rölaps sıklığı 1 / 19.1 hasta ayı, kontrol grubunda ise 1/16 hasta ayı olarak bulundu ve arada istatistiksel olarak anlamlı fark saptandı (p < 0.05). Çalışma grubunda rölapslardaki enfeksiyon oranı % 62.5, kontrol grubunda % 55.5 olarak bulundu ve arada anlamlı fark tesbit edildi (p < 0.01). Aşı öncesi izlem süresi bir yılın üzerinde olan 13 hastanın rölaps sıklığında aşı sonrası 1 /13.3 ±1 / 57.14 hasta ayı kadar düşüş olduğu saptandı ve istatistiksel olarak anlamlı bulundu (p < 0.01). Çalışma grubunda aşı öncesi ve sonrası rölapslardaki enfeksiyon oranında ise anlamlı düşme görüldü (p < 0.001). Sonuç olarak pnömokok aşısının nefrotik sendromlu çocuklarda rölaps sıklığını ve enfeksiyon oranını azalttığı gösterilerek bu çocukların rutin olarak aşılanmasının yararlı olabileceği sonucuna varıldı.
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