1855例狂犬疫苗接种后不良反应文献的分析

Literature Analysis of 1855 Cases of Adverse Reactions Induced by Rabies Vaccine

目的：探讨狂犬疫苗接种后不良反应的一般规律及特点，为观察狂犬疫苗不良反应提供参考。方法检索1975～2014年中国知网中公开报道的有关狂犬疫苗不良反应的个案病例报道，并进行分类统计与分析。结果共检索到173篇符合标准的文献，合计1855例；在本次统计的病例中，不良反应以20～40岁居多，占40.92%。不良反应多发生于注射后1～12 h内，达到45.56%，以第1、3、4针较多。Vero细胞培养的疫苗不良反应发生率最高，构成比为54.49%，多为皮肤系统疾病；其次为原代地鼠肾细胞培养的疫苗不良反应，构成比为41.46%，多为过敏反应。动物脑组织狂犬疫苗以神经系统并发症为主，构成比为3.49%。结论狂犬疫苗引起不良反应的原因较多，临床应加以重视，在接种时和接种后都应密切监察，以减少不良反应的发生并及时抢救。

Objective To discuss the general pattern and characteristics of adverse reactions induced by rabies vaccine, provide references for the observation of adverse reactions induced by rabies vaccine. Methods Adverse reactions induced by rabies vaccine reported in the literature database CNKI from1975-2014 were researched and analyzed statistically. Results A total of 173 related literatures were eligible with 1 855 cases in total. Among these cases, 40.92% occurred mostly in patients aged from 20 to 40 years old. Most adverse reactions （up to 45.56%） took place within 1-12 h after injection of the vaccine, mainly happening after 1st, 3rd, 4th injection. The incidence of adverse reactions for the culture of Vero cells was the highest, accounting for 54.49% with most adverse reactions of skin system, followed by primary hamster kidney cell culture vaccine accounting for 41.46%with most adverse reactions of allergy. The adverse reactions for animal brain tissue vaccine are mainly nervous system complications reaching to 3.49%. Conclusion The causes of adverse reactions induced by rabies vaccine were miscellaneous. Clinicians and pharmacists should pay attention to the clinical use of rabies vaccine. Patients should also be monitored strictly during pre- and post-injection to reduce the incidences of adverse reactions and give rescue timely.