中国2009-2012年急性播散性脑脊髓炎疑似预防接种异常反应监测数据分析  

Analysis on Surveillance Data of Acute Disseminated Encephalomyelitis as Adverse Events Following Immunization in China,2009-2012

作　　者：武文娣[1] 刘大卫[1] 王亚敏[1] 李克莉[1] 许涤沙[1] 杨宏[1] 郑景山[1] 曹雷[1] 王华庆[1] 李黎[1] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050

出　　处：《中国疫苗和免疫》2014年第1期26-30,50,共6页Chinese Journal of Vaccines and Immunization

摘　　要：目的分析中国2009~2012年疑似预防接种异常反应（Adverse Events Following Immunization,AEFI）监测（未包括香港、澳门特别行政区和台湾地区,下同）中,接种疫苗后急性播散性脑脊髓炎（Acute Disseminated Encephalomyelitis,ADEM）的发生特征,评价接种疫苗后ADEM的发生风险。方法通过中国AEFI信息管理系统,收集截至2013年8月21日报告的2009~2012年发生的诊断为ADEM的AEFI个案数据,采用描述流行病学方法进行分析。结果中国2009~2012年AEFI信息管理系统共收到ADEM 57例,分布在19个省（自治区、直辖市）,男女性别比为1.03∶1,45.61%的病例≤4岁。ADEM病例涉及14种疫苗,估算报告发生率在0.005/100万剂~0.07/100万剂,其中报告例数最多的是人用狂犬病疫苗。57例ADEM中,54.39%发生在接种后〈1周。41例被判定为预防接种异常反应,其中38例发生在接种后≤4周。结论中国预防接种后ADEM报告发生率低,未发现接种疫苗后ADEM发生风险增高。需继续加强预防接种后ADEM的监测、调查诊断和处置,开展预防接种后ADEM的诊断标准制定研究,为正确认识接种疫苗后ADEM发生风险提供依据。Objective The study is to analyze the occurrence features of acute disseminated encephalomyelitis （ADEM） as adverse event following immunization （AEFI） in China （not include Hong Kong Special Administrative Region, Macao Special Administrative Region and Taiwan Sheng） , and to evaluate the occurrence risk of ADEM after vaccination. Methods Surveillance data of ADEM in 2009-2012 were collected through the national AEFI information management system, which were reported before August 21, 2013. The descriptive methodology was used in the study. Results 57 ADEM cases were collected in 2009-2012 from national AEFI information system, which were reported from 19 provinces. The ratio of male to female was 1.03： 1.45. 61% of cases were ≤4 years old. 14 kinds of vaccines were involved, with a range of 0. 005 per 1000 000 doses-0. 07 per 1000 000 doses for the estimated incidence rate. The highest reported cases was from rabies vaccine human used. In all 57 cases, 54.39% occurred within 1 week after vaccination. 41 cases were classified as rare vaccine reaction, in which 38 cases were occurred within 4 weeks after vaccination. Conclusions The estimated incidence of ADEM after vaccination was very low. No evidence showed that vaccination would increase the risk of ADEM. It is necessary to strengthen the monitoring, causality assessment and treatment of ADEM as AEFI, and to develop the standard diagnosis of ADEM related to vaccine for better understanding the risk of ADEM after vaccination.

关 键 词：疑似预防接种异常反应 急性播散性脑脊髓炎 监测 

分 类 号：R186[医药卫生—流行病学]