接种卡介苗发生淋巴结核、肺结核并且偶合右眼睑血管瘤、先天性心脏病1例的调查

Investigation of one case of lymph node tuberculosis and pulmonary tu-berculosis coupling with right eyelid hemangioma and congenital heart disease after the inoculation of BCG

接种卡介苗后的预防接种不良反应（adverseevents following immunization，AEFI）不少见，但异常反应（rarereactions，RR）属于罕见事件。某新生儿在出生后24h内分别接种乙型肝炎疫苗和卡介苗，在出生后1～3个月的时间，先后发现患有右眼睑血管瘤、先天性心脏病，于2013年5月中旬左侧腋窝出现淋巴结节肿大，于2013年6月中旬肺部cT检查发现肺部有浸润阴影，于2013年7月下旬在上海市（复旦大学）附属公共卫生临床中心就诊．主要诊断为“淋巴结结核、肺结核”，并行“淋巴结穿刺术”，病灶标本经病理证实。预防接种不良反应调查诊断结论是：该病例在接种卡介苗后发生的淋巴结核、肺结核与卡介苗有关，属于异常反应，而右眼睑血管瘤、先天性心脏病与接种卡介苗无关。对近年来接种卡介苗后常见的不良反应、应对措施以及偶合其他疾病的文献进行概述。

The adverse events following immunization （AEFI） after the inoculation of BCG are not uncommon, but rare reactions （RR） belong to rare events. A newborn was inoculated with hepatitis B vaccine and BCG respectively within 24 hours after birth. During 1 month to 3 months after birth, right eyelid hemangioma and congenital heart disease were detected respectively, enlargement of lymph nodes were detected on the left armpit in the mid May, 2013, and infiltrated shadow in the lungs was seen by lung CT in the mid June, 2013. The patients were diagnosed in Shanghai Public Health Clinical Center in the late July, 2013. The main diagnosis was ＂tuberculosis of lymph nodes and lungs＂, and lymph node puncture was performed. The specimens of lesions were pathologically confirmed. The diagnosis conclusion in the investigation of preventing AEFI is： the tuberculosis of lymph nodes and lungs after the inoculation of BCG are associated with BCG, and belong to adverse reactions. The right right eyelid hemangioma and congenital heart disease are not associated with BCG vaccination. The literature articles related to the common adverse reactions after the inoculation of BCG, tackling measures and other coupling diseases in recent years are summarized.