无细胞百白破联合疫苗/白喉破伤风联合疫苗接种后硬结反应观察及消退影响因素分析  

Observation of induration reactions and factors influencing their resolution after vaccination with diphtheria,tetanus and acellular pertussis combined vaccine/diphtheria and tetanus combined vaccine

作　　者：骆晓艳[1] 高志刚[1] 李永成[1] 曲江文[1] 黄海涛[1] 张颖[1] 

机构地区：[1]天津市疾病预防控制中心,天津300011

出　　处：《中国疫苗和免疫》2017年第2期191-195,共5页Chinese Journal of Vaccines and Immunization

摘　　要：目的探讨无细胞百白破联合疫苗(DTaP)/白喉破伤风联合疫苗(DT)接种后硬结发生情况及消退的影响因素。方法 2015年5月-2016年4月对天津市接种DTaP和DT后单纯出现硬结反应的儿童进行监测,使用自行设计的调查表开展调查,对数据进行统计学分析。结果共监测到DTaP/DT接种后单纯硬结反应的儿童390例,发生率为78.99/10万,男女发生数之比为1.5∶1,4-8月份发生数占62.31%。DTaP第1-4剂次硬结发生率分别为30.63/10万、57.80/10万、69.09/10万、155.82/10万(χ~2=109.72,P=0.000)。接种疫苗后发现硬结的时间中位数为24h。硬结的平均直径为2.62(±1.71)cm,并随着接种剂次的增加而增大(F=21.90,P=0.000)。硬结越大发现越早(F=7.43,P=0.000)。硬结干预措施的实施率达74.10%。发生硬结后14d内的消退率为78.72%,接种剂次、硬结大小及干预措施对硬结的消退有影响。结论 DTaP和DT接种后易出现硬结反应,且发生率随着接种剂次的增加而增高。及时发现和采取干预措施易于硬结的消退。Objective To analyze induration reactions of diphtheria, tetanus and acellular pertussis combined vaccine （DTaP） / diphtheria and tetanus combined vaccine （ DT）, and factors influencing the res-olution of induration. Methods Induration reactions after DTaP/DT vaccination in children were monitored during May 2015-April 2016 in Tianjin. We used a questionnaire for gathering information about cases. Data were analyzed descriptively. Results 390 induration cases that followed DTaP/DT vaccination were reported, for an incidence of 78.99 per 100 000 doses. The male to female ratio was 1.5： 1; 62. 31% of cases occurred from April to August. The incidence rates of induration reactions following DTaP1, DTaP2, DTaP3, and DTaP4 were 30. 63, 57.80, 69.09, and 155.82 per 100 000 doses （X2 = 109. 72 ,P = 0. 000）, respectively. The median time to discovery of induration reactions following DTaP/ DT vaccination was 24 hours. The mean diameter of induration reactions was 2. 62 （ ＋ 1.71 ） cm, and in- creased with increasing number of doses administered （ F = 21.90, P = 0. 000）. Larger induration reac- tions were discovered earlier than smaller reactions （ F = 7.43, P = 0. 000）. 74. 1% of cases received treatment. 78.72% of induration reactions faded within 14d. The number of doses administered to an in- dividual, the size of the induration, and treatment given were factors that influenced resolution of induration reactions. Conclusions Induration reactions commonly occur after DTaP/DT vaccination, and the incidence of induration increases with increasing numbers of doses administered. Early discovery and treatment are associated with resolution of induration reactions.

关 键 词：无细胞百白破联合疫苗 白喉破伤风联合疫苗 硬结 消退 影响因素 

分 类 号：R186[医药卫生—流行病学]