1例接种甲型肝炎减毒活疫苗和麻腮风联合减毒活疫苗偶合肾病综合征调查  

Investigation of a case with nephrotic syndrome coupled to vaccinations with live attenuated hepatitis A vaccine and measles,mumps and rubella combined attenuated live vaccine

作　　者：韩芳 马敬仓[1] 沙娜 刘景顺[1] 徐凌忠[3] HAN Fang;MA Jingcang;SHA Na;LIU Jingshun;XU Lingzhong(Heze Center for Disease Control and Prevention,Shandong 274010,China;不详)

机构地区：[1]菏泽市疾病预防控制中心,山东274010 [2]济宁市第一人民医院 [3]山东大学公共卫生学院

出　　处：《医学动物防制》2023年第4期384-388,共5页Journal of Medical Pest Control

基　　金：国家自然科学基金委员会面上项目(71974118)。

摘　　要：目的调查某肾病综合征病例发病是否为注射疫苗所引起。方法对病例开展个案调查,调取受种儿童出生病历、住院病历,收集疫苗生产企业信息与疫苗质量情况、接种方信息等。某市级调查诊断专家组对该疑似预防接种异常反应(adverse events following immunization,AEFI)开展调查诊断,得出结论。结果该病例于2021年6月25日接种甲型肝炎(甲肝)减毒活疫苗(live attenuated hepatitis A vaccine,HepA-L)和麻腮风联合减毒活疫苗(measles,mumps and rubella combined attenuated live vaccine,MMR),留观30min无异常。受种儿童于2021年7月8日至2021年7月19日在甲医院以“眼睑水肿8天,阴囊水肿4天”住院治疗,出院诊断为“原发性肾病综合征、泌尿系感染”。于2021年8月8日至2021年11月23日在乙医院以“反复水肿1月余”住院治疗,出院诊断为“肾病综合征”。2种疫苗质量合格,疫苗接种符合技术标准和操作规程。某市级预防接种异常反应调查诊断专家组诊断为“不属于预防接种异常反应”。结论无证据表明该病例接种疫苗后发生的肾病综合征与疫苗接种有关,经专家组判定属于偶合反应。Objective To investigate whether a case of nephrotic syndrome was caused by vaccine injection.Methods The case was investigated on a case-by-case basis,and the birth and hospitalization records of the vaccinated child were retrieved,as well as the information of the vaccine manufacturer,the quality of the vaccine,and the inoculating party was collected.A municipal investigation and diagnosis panel investigated and diagnosed the case of the suspected adverse events following immunization(AEFI),and drew the conclusion.Results The case was vaccinated with live attenuated hepatitis A vaccine(HepA-L)and measles,mumps and rubella combined attenuated live vaccine(MMR)on June 25,2021,and no abnormalities were observed for 30 minutes after inoculation.The vaccinated child was hospitalized in Hospital A from July 8,2021 to July 19,2021 with the chief complaint of“eyelid edema for 8 days and scrotal edema for 4 days”and was discharged with the diagnosis of“primary nephrotic syndrome and urinary tract infection”.From August 8,2021 to November 23,2021,the recipient was hospitalized in Hospital B with the chief complaint of“recurrent edema for more than one month”and was discharged with the diagnosis of“nephrotic syndrome”.The quality of the two vaccines were qualified and the vaccination met the technical standards and operational procedures.The municipal investigation and diagnosis panel for abnormal reaction to vaccination diagnosed the case as not an AEFI.Conclusion No evidence suggested that the nephrotic syndrome occurred after vaccination in this case is related to vaccination,and the case is determined to be a coupled reaction by the panel.

关 键 词：肾病综合征 疫苗 预防接种 偶合反应 儿童 分析 相关性 调查 

分 类 号：R725.8[医药卫生—儿科]