川崎症治療後，為何要延後麻疹腮腺炎德國麻疹（MMR）疫苗接種？
根據統計，川崎症好發於五歲以下的幼童，尤其在亞洲國家盛行率較高。今天想跟大家聊聊一個關於川崎症治療後的重要議題：為什麼需要延後接種麻疹、腮腺炎、德國麻疹混合疫苗（MMR）呢？
川崎症是一種好發於五歲以下幼兒的急性發炎症狀，其最主要的治療方式是靜脈注射免疫球蛋白（IVIG）合併阿斯匹靈。根據長庚醫院的資訊，川崎症的標準治療包括在發燒黃金期（五到十天內）給予靜脈注射單次高劑量免疫球蛋白（2gm／Kg／dose）及合併使用阿斯匹靈。IVIG如同體內免疫系統的調節劑，能有效抑制過度活化的免疫反應，降低發炎症狀，保護心臟血管免受損害。
然而，這個強大的免疫調節作用也正是延後接種MMR疫苗的關鍵原因。
根據文獻，高劑量靜脈注射免疫球蛋白（IVIG）具有多種藥理抑制作用，包含抑制吞噬作用、補體系統、致病性自體抗體和發炎細胞激素，使其成為治療自體免疫疾病的有效方法。
簡而言之，IVIG就像一位戰場上的指揮官，能夠調控免疫大軍的行動，抑制過度激烈的攻擊，讓戰場（也就是我們的身體）恢復和平。
MMR疫苗是一種減毒活疫苗，也就是將活性減弱的麻疹、腮腺炎、德國麻疹病毒注射到體內，刺激免疫系統產生對應的抗體，形成記憶，預防未來真正的病毒感染。衛生福利部也提醒，COVID-19疫苗的接種禁忌症主要包括對疫苗成分有嚴重過敏反應史，或對於先前接種之疫苗劑次發生嚴重過敏反應者。
這就好比讓免疫大軍進行一場模擬演習，認識病毒的樣貌，學習應對策略，以便未來真正開戰時能夠迅速有效地擊退敵人。
IVIG與MMR疫苗的衝突
問題來了，如果在接受IVIG治療後不久就接種MMR疫苗，會發生什麼事呢？
由於IVIG具有抑制免疫反應的作用，它可能會削弱MMR疫苗的效力，如同演習時指揮官下令士兵們收斂攻擊，導致士兵無法充分學習敵人的特性，降低了演習的效果。因此根據衛福部的建議，接受IVIG治療的患者，需要延遲11個月後才可以接種活性疫苗，以避免免疫球蛋白影響疫苗的功效。
換句話說，IVIG可能會干擾免疫系統對MMR疫苗的反應，使身體無法產生足夠的抗體，降低疫苗的保護力，孩子日後仍有可能感染麻疹、腮腺炎、德國麻疹。
因此，為了確保MMR疫苗的有效性，醫師通常會建議川崎症病童在接受IVIG治療後延後接種MMR疫苗。這篇文章強調了及時診斷和治療的重要性，以及在出院後的居家護理和追蹤檢查。
延後接種的時間長短會根據IVIG的劑量和孩子的個別情況而有所不同，一般建議至少延後數個月，甚至一年。確切的接種時間需要與主治醫師討論，醫師會根據孩子的病情和免疫狀況，制定最適合的疫苗接種計劃。
結語
IVIG是治療川崎症的重要藥物，可以抑制過度活化的免疫反應；MMR疫苗是預防麻疹、腮腺炎、德國麻疹的有效方法，透過刺激免疫系統產生抗體來達到保護作用。但IVIG可能會降低MMR疫苗的效力，因此川崎症病童需要延後接種MMR疫苗。延後接種的時間長短需與醫師討論，以確保疫苗的有效性。
希望以上說明能幫助各位家長了解川崎症治療後延後接種MMR疫苗的原因。如果您還有任何疑問，請務必諮詢您的主治醫師，以獲得最專業的醫療建議。
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