近年预防接种引起紫癜的回顾性调查

A Retrospective Survey of the Purpura Symptom after Vaccination with Varies Vaccine in Recent Years

目的加强对接种疫苗出现的不良反应进行监测,总结和评估不同疫苗引起紫癜的临床特征、诊断要点、治疗原则及应对措施。方法对1994~2005年报道的3类预防接种引起紫癜156例进行回顾性流行病学调查。结果156例紫癜的年龄为8日龄~46岁,首发时间为接种疫苗后1h^15d,除1例死亡外,其余均治愈,治疗时间为5d^6个月。3类预防接种方式中,麻疹减毒活疫苗等8种预防接种既可以引起血小板减少性紫癜,也可引起过敏性紫癜,有时还会并发紫癜性肾炎、关节性紫癜等;麻疹-流行性腮腺炎-风疹联合减毒活疫苗等4种预防接种一般只引起血小板减少性紫癜;脑膜炎球菌多糖疫苗等9种预防接种一般只引起过敏性紫癜。结论预防接种后发生紫癜的原因与受种者自身体质、接种当时体质、疫苗质量、疫苗联合免疫方式等可能有关。

Objective To strengthen the monitoring of the Adverse Events Following immunization（AEFI）. To summerize and evaluate the purpura of clinical symptom, key criteria of diagnosis,principle of remedy and measures caused by varies vaccines. Methods A retrospective epidemiologic survey was conducted to 156 cases of purpura in 1994-2005. Results The age of cases of purpura covered from 8 days to 46 years old. The cases occurred in 1 hour to 15 days after vaccination. Except one case was dead, the others were recovevred from 5 days to 6 months. Thrombocytopenia purpura and hypersusceptibility purpura happened after administered with 8 kinds of attenuated live vaccines. Sometimes nephritis or arthritis also occurred. Thrombocytopenia purpuria only happened after administered 4 vaccines, 4 kinds of vaccine including MMR. Hypersusceptibility purpura only happened after 9 kinds of vaccines administered, such as epidemic encephalitis vaccine. Conclusions The occurence of purpura had close relations with the health condition of the person, the corporeity of the person when administering vaccines, quality of vaccine, mode of the unite immunity.