狂犬病疫苗和狂犬病免疫球蛋白联用免疫效果观察

Observation on the results of immunization with human rabies immunoglobulin

目的了解暴露人群使用人狂犬病免疫球蛋白的作用效果和不良反应情况,进一步推广人狂犬病免疫球蛋白的应用。方法将狂犬病暴露人群根据其暴露程度分别采用联合使用狂犬病疫苗与人狂犬病免疫球蛋白和仅注射狂犬病疫苗。对这两组人群在首针免疫后3d及全程免疫15d后的体内抗狂犬病病毒IgG抗体水平进行检测,观察其抗体阳性率及不良反应情况。结果联合使用狂犬病疫苗与人狂犬病免疫球蛋白进行狂犬病预防的人群,其首针疫苗注射3d后的抗体阳性率为91.1%,全程接种15d后的抗体阳性率为98.8%,全身不良反应发生率为3.5%,局部反应发生率为1.3%;单纯使用狂犬病疫苗,相应时间的抗体阳性率分别为0和95.2%,全身不良反应发生率为3.1%,局部反应发生率为1.1%。两者抗体阳性率的差别均具有统计学意义,而不良反应的差别无统计学意义(P>0.05)。结论狂犬病疫苗与人狂犬病免疫球蛋白联合使用,可使体内更早出现抗狂犬病病毒抗体,全程接种后抗体阳性率也高于单纯注射狂犬病疫苗的人群。注射人狂犬病免疫球蛋白后无明显不良反应。

Objective To understand the effect and the adverse reactions in exposed population immunized with rabies immune globulin. Methods Based on the exposed extent, people exposed to rabies were divided into two groups, one immunized with rabies vaccine and rabies immune globulin, another one were only injected with rabies vaccine. The level of IgG antibody in subjects of the two groups were determined 3 and 15 days after immunization. Results The antibody positive rates in the groups immunized with rabies vaccine and rabies immunoglobulin 3 and 15 days after immunization were 91.1% and 98.8%, showing significant difference with general adverse reactions and local reaction of 3.5% and 13%. The antibody positive rates in the subjects immunized with rabies vaccine alone 3 and 15 days after immunization were 0 and 95.2 % with general adverse reactions and local reaction of 3. 1% and 1. 1%. Conclusion Antibody to rabies virus can appear early in subjects immunized with rabies vaccine and immunoglobulin without apparent adverse reactions.