新型冠状病毒疫苗相关的皮肤不良反应分析

Analysis of COVID-19 vaccination-related cutaneous adverse reactions

目的探讨巢湖市接种新型冠状病毒疫苗(新冠疫苗)后皮肤不良反应(CADRs)的发生情况。方法选取2021年1―12月在安徽医科大学附属巢湖医院就诊的接种新冠疫苗后发生CADRs病人270例,并对其临床资料进行统计分析。结果270例CADRs病人中男112例(41.48%),女158例(58.52%),年龄范围为4~90岁,年龄(44.04±21.41)岁;CADRs发生时间主要集中在新冠疫苗接种后7 d内(216例,80.0%);CADRs类型主要包括荨麻疹(85例,31.48%)、接种部位局部红肿(80例,29.63%)、非特异性皮疹(78例,28.89%)等;根据药物不良反应关联度评价,将皮疹表现类型分为很可能、可能及不明确三种,其中很可能的皮疹(80例,29.63%)、可能(177例,65.56%)、不明确(13例,4.81%)。根据引起皮肤不良反应的疫苗种类分为灭活疫苗(142例,52.60%)、重组疫苗(128例,47.40%);引起CADRs的新冠疫苗接种剂次以第1剂次居多(178例,65.92%)。结论接种新冠疫苗后发生的CADRs中,以接种灭活疫苗多见,第1剂次居多,多见于中年女性,临床症状以荨麻疹表现最常见。所有病人经有效治疗均痊愈,且不遗留后遗症。应正确看待疫苗接种引起的CADRs,鼓励全员积极接种疫苗,共筑免疫屏障。

Objective To investigate the clinical manifestations and characteristics of cutaneous adverse reactions after receiving COVID-19 vaccines in Chaohu City,Anhui Province.Methods A total of 270 patients who had CADRs in Chaohu Hospital of Anhui Medical University after COVID-19 vaccination from January to December 2021 were selected for the study,whose general condition,clinical manifestations latency time,etc were analyzed.Results Among the 270 patients with CADRs,112(41.48%)were males and 158(58.52%)were females,with an average age of(44.04±21.41)years,ranging from 4 to 90 years old.CADRs mainly occurred within 7 days after the COVID-19 vaccination(216 cases,80.0%);The types of CADRs mainly included urticaria(85 cases,31.48%),local redness and swelling at the vaccination site(80 cases,29.63%),non-specific rash(78 cases,28.89%),etc.Based on the correlation evaluation of the adverse drug reactions,clinical rash manifestations were classified into three types:probable,possible and unclear,of which the most probable rashes(80 cases,29.63%);Possible(177 cases,65.56%);Unclear(13 cases,4.81%).According to the types of vaccines that cause adverse skin reactions,they are divided into inactivated vaccine(142 cases,52.60%)and recombinant vaccine(128 cases,47.40%);The first dose of COVID-19 vaccine was the most frequently used to cause CADRs(178 cases,65.92%).Conclusions The skin adverse reactions caused by COVID-19 vaccines are more common in women.Urticarial rashes are the most frequently observed,and most cutaneous adverse reactions occurre within one week after vaccination.The skin adverse reactions caused by inactivated vaccines are more common,and the first dose is the most frequent.After active and effective treatment,it can be cured without leaving sequelae.Therefore,dermatologists should correctly view the adverse reactions caused by vaccination,and encourage all employees to actively vaccinate and build an immune barrier.