中国2008~2012年预防接种后过敏性皮疹监测分析

Analysis of Surveillance for Anaphylactic Rash after Immunization in China,2008-2012

目的分析中国疑似预防接种异常反应（Adverse Events Following Immunization,AEFI）信息管理系统（未包括香港、澳门特别行政区和台湾地区,下同）中,接种疫苗后过敏性皮疹的发生特征,为规范接种疫苗后过敏性皮疹的报告、诊断提供参考。方法收集中国2008~2012年AEFI信息管理系统中,诊断为过敏性皮疹（包括最终临床诊断为过敏性皮疹、荨麻疹、麻疹猩红热样皮疹和斑丘疹）的个案数据,采用描述性流行病学方法对相关指标进行分析。结果中国2008~2012年共报告过敏性皮疹19 888例,其中19 655例（98.83%）分类为异常反应。在19 655例异常反应中,东、中、西部地区分别占68.68%、21.09%、10.23%;男、女性别比为1.34∶1;≤1岁儿童占69.81%;第三季度报告数占35.56%;第1剂占68.79%;不伴发热的占72.24%;发生在接种后≤1d的占82.60%。报告发生率之高居前五位的疫苗为：7价肺炎球菌多糖结合疫苗（186.89/100万剂）,麻疹减毒活疫苗（112.76/100万剂）,麻疹-风疹联合减毒活疫苗（38.91/100万剂）,无细胞百日咳-白喉-破伤风-灭活脊髓灰质炎-b型流行性感冒嗜血杆菌联合疫苗（27.46/100万剂）,麻疹-流行性腮腺炎联合减毒活疫苗（27.30/100万剂）。结论结合过敏性皮疹的发生特点,报告时需加强过敏性皮疹等各类皮疹的鉴别;对部分疫苗过敏性皮疹报告发生率相对较高需进一步分析研究。

Objective To analyze the characteristics of anaphylactic rash after vaccination in China, of the adverse event following immunization （AEFI） information management system （not include Hong Kong Special Administrative Region, Macao Special Administrative Region and Taiwan Sheng）during 2008-2012, and to provide evidence for standardization of anaphylactic rash case reporting and diagnosis. Methods Data of anaphylaetic rash cases reported during 2008-2012 were collected through the national AEFI information management system. The descriptive methodology was used in this study. Results 19,888 anaphylactie rash cases were reported, of which 19,655 eases（98.83% ） were classified as rare, more serious vaccine reactions. Anaphylactic rash cases in the eastern, middle, and western areas accounted for 68.68% ,21.09% , 10. 23% , respectively, and the sex ratio（male to female）was 1.34： 1. The cases most commonly occurred in the age group of ≤ 1 year old, and in the third quarter of the year. The anaphylactic rash mostly occurred after the first dose of immunization and within l d after immunization. The estimated reported rates for top five vaccines were 186. 89,112.76,38.91,27.46and 27.30 per million doses for 7-valent pneumococcal polysaccharide conjugate vaccine; measles attenuated live vaccine; measles and rubella combined attenuated live vaccine ; diaphtheria, tetanus and acellular pertussis- inactivated poliomyelitis-haemophilus influenza type b combined vaccine;and measles and mumps combined attenuated live vaccine, respectively. Condusions The ability of distinguishing all kinds of rashes needs to be strengthened. Vaccines with highest imated reported rates should be further studied.