暴露者狂犬病疫苗4针免疫法和5针免疫法安全性对比分析

Comparative analysis on safety of rabies vaccine phases 4 and 5 immunization for exposed persons

目的对狂犬病疫苗4针免疫法和5针免疫法的安全性进行对比评估。方法 182例动物不同程度咬伤后暴露者为研究对象,按随机数字表法分为对照组和研究组,各91例。研究组按2-1-1四针免疫法,在暴露后当天在上臂三角肌肌内注射2针疫苗,然后于暴露后第7、21 d分别于暴露者同一部位各注射1针疫苗。对照组采用传统5针免疫法,按暴露后第0、3、7、18和21 d分别于暴露者上臂三角肌各肌内注射1针疫苗。对两组患者安全性进行对比评估。结果研究组发生不良反应12例(13.18%);对照组发生不良反应14例(15.38%),两组比较差异无统计学意义(P>0.05)。两组全身反应中以发热为主,研究组发生率为8.89%,对照组发生率为7.69%;两组局部不良反应主要为红肿和疼痛,研究组红肿和疼痛的发生率分别为10.9%和10.9%,对照组红肿和疼痛的发生率分别为12.1%和13.2%,两组比较差异无统计学意义(P>0.05)。研究组患者出现不良反应平均时间为(12.36±1.21)h,早于对照组的(14.13±2.31)h。研究组症状持续平均时间为(36.42±4.73)h,长于对照组的(34.87±6.28)h,但差异无统计学意义(P>0.05)。结论两种免疫方案安全性相当,但4针免疫方案接种次数少、程序简便、成本低且患者依从性高,值得推广。

Objective To compare and evaluate the safety of rabies vaccine phases4and5immunizationfor exposed persons.Methods A total of182exposed persons with different level of animal bite were divided byrandom number table method into control group and research group,with91cases in each group.The researchgroup received2-1-1phases4immunization,with2vaccine by intramuscular injection on upper arm deltoidmuscle on the day of exposure,and1vaccine injection respectively on7and21d after exposure on the same part.The control group received traditional phases5immunization,with1vaccine by intramuscular injection on upperarm deltoid muscle respectively on0,3,7,18and21d after exposure.Safety was compared and evaluated in twogroups.Results The research group had12cases with adverse reactions(13.18%),while the control group had14cases with adverse reactions(15.38%),the difference had no statistical significance(P>0.05).Fever was themain general reaction in two groups,which was8.89%in the research group and7.69%in the control group.Redand swollen and pain were the main local adverse reactions in two groups,which were10.9%and10.9%in theresearch group and12.1%and13.2%in the control group.Both groups had no statistically significant difference(P>0.05).The research group had earlier mean adverse reaction time as(12.36±1.21)h than(14.13±2.31)hin the control group.The research group had longer mean symptom continuous time as(36.42±4.73)h than(34.87±6.28)h in the control group,but the difference had no statistical significance(P>0.05).Conclusion Bothimmunizations have equal safety,but phase4immunization shows fewer vaccinations,simple process,low cost and high patient compliance,and it is worth promoting.