婴幼儿疫苗接种相关外周血细胞变化特点分析

Trend Change of Blood Routine Examination Indexes after Vaccination in Infants

目的:分析婴幼儿疫苗接种后外周血液细胞的变化特点,为儿童健康管理工作提供参考。方法:选取2019年3月—2021年7月在重庆佑佑宝贝妇儿医院进行预防接种,且接种后第1~14天(采血日期与疫苗接种日期相减)在该院儿童保健门诊进行过血常规检测的儿童162例,根据采血日期与婴幼儿疫苗接种日期的间隔天数不同,将其分为接种后1~3天组、4~7天组、8~14天组,采用SPSS 23.0软件对其血常规指标进行统计分析。结果:共收集了162名研究对象的血常规结果,其中1~3天组26人,4~7天组52人,8~14天组84人。疫苗接种后3组婴幼儿中性粒细胞绝对值、单核细胞绝对值、嗜酸粒细胞绝对值比较,呈下降趋势,差异均有统计学意义(F值分别为14.168、9.185、8.740,P<0.05);淋巴细胞绝对值在3组间呈上升趋势,白细胞计数短暂下降又回升,差异有统计学意义(F=3.295,P<0.05)。红细胞计数、血红蛋白、血小板计数在疫苗接种后各组间比较,差异无统计学意义(P>0.05)。5.6%(9/162)的儿童出现中性粒细胞减少症(ANC<1.0×10~9/L),12.1%(33/162)白细胞计数>10×1012/L,11.7%(19/162)出现血小板增多症(PLT>450×10~9/L),未发现有血小板减少症(PLT<100×10~9/L)。结论:婴幼儿疫苗接种2周内,其外周血白细胞、中性粒细胞、单核细胞、嗜酸性粒细胞具有特征性的变化趋势,疫苗接种可导致部分正常健康婴幼儿白细胞计数、中性粒细胞绝对值短期偏离,可达到疾病诊断标准。在儿童健康管理工作中,对0~1岁婴幼儿血常规指标进行分析时需要考虑疫苗接种对血常规的短期影响效应。

OBJECTIVE To analyze the changes of peripheral blood cells in infants and young children after vaccination,and to provide reference for children’s health management.METHODS A total of 162 children who were vaccinated in Chongqing Youyou Baby Women’s and Children’s Hospital from March 2019 to July 2021 and underwent routine blood tests in the Children’s health Clinic of the hospital from the 1st to 14th day after vaccination(the date of blood collection minus the date of vaccination)were select⁃ed.They were divided into 1~3 days after inoculation,4~7 days and 8~14 days.The blood routine indexes were analyzed by SPSS 23.0 software.RESULTS Blood routine results of 162 subjects were collected,including 26 in the 1~3 day group,52 in the 4~7 day group,and 84 in the 8~14 day group.After vaccination,the absolute values of neutrophils,monocytes and eosinophils in 3 groups showed a decreasing trend,and the differences were statistically significant(F=14.168,9.185,8.740,P<0.05).The absolute value of lymphocytes increased among the three groups,and the white blood cell count briefly decreased and then increased,the difference was statistically significant(F=3.295,P<0.05).There was no significant difference in red blood cell count,hemoglobin count and platelet count among all groups after vaccination(P>0.05).5.6%(9/162)of the children had neutropenia(ANC<1.0×109/L),12.1%(33/162)had white blood cell count>10×1012/L,11.7%(19/162)had thrombocytopenia(PLT>450×109/L).No thrombocytopenia was found(PLT<100×109/L).CONCLUSION Within 2 weeks of vaccination,the peripheral blood leukocytes,neutrophils,monocytes and eosinophils of infants and young children showed characteristic changes.Vaccination could lead to short-term deviation of leukocyte count and absolute value of neutrophils in some normal healthy infants and young children,which could meet the diagnostic criteria for diseases.In the work of children’s health management,the short-term effect of vaccination on blood routine should be consid⁃ered when analyzing the blood routine indexes of 0~1-year-old infants.