上海市2007～2010年预防接种后血小板减少性紫癜监测分析  

Analysis of Idiopathic Thrombocytopaenic Purpura after Immunization in Shanghai, 2007-2010

作　　者：胡家瑜[1] 白庆瑞[1] 杨建萍[1] 秦晓东[1] 陶黎纳[1] 袁政安[1] 

机构地区：[1]上海市疾病预防控制中心,上海200336

出　　处：《中国疫苗和免疫》2012年第4期358-360,366,共4页Chinese Journal of Vaccines and Immunization

摘　　要：目的分析预防接种后特发性血小板减少性紫癜(Idiopathic Thrombocytopaenic Purpura,ITP)的发病特征,评价预防接种的安全性。方法通过上海市疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)监测系统,收集2007～2010年23例预防接种后ITP病例,采用描述性方法对个案调查资料进行流行病学分析。结果接种疫苗后ITP好发于≤2岁儿童,其中<1岁占47.83%,1～2岁占30.43%;男女性别比为2.29∶1。接种后≤1d发生5例,≥15d发生5例,接种至发生的最短时间间隔为数小时,最长51d。在报告预防接种后ITP病例中,涉及9种疫苗。其中无细胞百日咳-白喉-破伤风联合疫苗8例,占34.78%,发生率为2.54/100万剂;麻疹减毒活疫苗7例,占30.43%,发生率1.97/100万剂。接种第1剂后发生的9例,占39.13%;接种第2剂后发生的7例,占30.43%。23例ITP中,最终判定为预防接种异常反应的5例,占21.74%;偶合症18例,占78.26%。2007～2010年各类疫苗预防接种后ITP报告发生率在0.28/100万剂～8.74/100万剂。结论上海市2007～2010年各类疫苗预防接种后ITP报告发生率低于世界卫生组织估计的预期发生率。预防接种后的ITP属于较严重疾病,必须建立规范的救治和补偿机制。Objective To analyze the characteristics of idiopathic thrombocytopaenic purpura （ITP） after vaccination and evaluate the safety of vaccination. Methods 23 ITP cases which occured from 2007 to 2009 were collected through Shanghai adverse events following immunization （AEFI） surveillance system. The surveillance data was analyzed through descriptive statistical analysis. Results ITP cases after vaccination were occured mainly in children less than 2 years old, The proportion of cases aged ≤ 1 year and 1 to 2 years old was 47.83% and 30.43% respectively. The ration of male to female was 2.29：1. There were 5 cases whose onset interval was ≤1d and 5 cases was ≥ 15d. The shortest onset interval was several hours and longest onset interval was 51d. There were 9 kinds of vaccine were involved with ITP. There were 8 cases related to diphtheria-tetanus-acellular pertussis combined vaccine which accounted for 34.78% and the reported rate was 2.54 per million. There were 7 cases related to measles attenualed live vaccine which accounted for 30.43% and the reported rate was 1.97 per million. 9 cases were occurred after first close （39,13%） and 7 cases were second dose （30.43%）. Among the 23 cases, 5 cases （21.74%） were finally diagnosis as rare adverse reaction and 18 cases （78.26%） were coincidental event. The annually reported rate of ITP after vaccination was 0.28-8.74 per million in 2007-2010. Conclusions The annually reported rate of ITP after vaccination in 2007-2010 was lower than the expected rate of WHO. ITP after vaccination was a serious disease, standardized mechanisms of compensation for ITP cases caused by vaccination should be established.

关 键 词：疑似预防接种异常反应 血小板减少性紫癜 监测 

分 类 号：R186[医药卫生—流行病学]