目的分析武汉市洪山区2010～2016年疑似预防接种异常反应(Adverse Event Following Immunization,AEFI)的发生特征,分析影响因素,提高监测敏感性。方法通过中国免疫规划信息管理系统和儿童预防接种报表信息,收集武汉市洪山区2010～2016...目的分析武汉市洪山区2010～2016年疑似预防接种异常反应(Adverse Event Following Immunization,AEFI)的发生特征,分析影响因素,提高监测敏感性。方法通过中国免疫规划信息管理系统和儿童预防接种报表信息,收集武汉市洪山区2010～2016年报告的AEFI个案数据及接种信息,采用描述性方法,对相关指标进行流行病学分析。结果 2010～2016年,洪山区共报告AEFI 385例,年平均报告率为17.85/10万剂,其中一般反应295例,占76.62%,临床表现以发热、红肿、硬结为主;异常反应72例,占18.70%,主要表现为过敏性皮疹(27.78%)、斑丘疹(40.28%)、荨麻疹(25%);严重异常反应3例(占比4.17%),其中过敏性紫癜2例,热性惊厥1例;无接种事故发生。反应多发生在2岁以下的儿童,占78.18%;每年4～9月份为AEFI报告高峰期;引起AEFI主要相关疫苗中,一类疫苗为白喉破伤风联合疫苗、乙型脑炎疫苗和含麻疹成分疫苗(40.43/10万),二类疫苗为百白破Hib联合疫苗、23价肺炎球菌多糖疫苗和无细胞百白破-灭活脊灰-b型流感嗜血杆菌联合疫苗;一类疫苗AEFI报告率为18.90/10万剂,高于二类疫苗的7.09/10万剂,差异有统计学意义(P<0.01);所有AEFI病例,均已治愈或好转,3例严重异常反应均已治愈,转归良好。结论武汉市洪山区AEFI监测系统运行良好,AEFI报告率与监测质量逐步提高,监测敏感性还需进一步提高。展开更多
Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been...Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been rarely reported. This study aimed to determine the etiology, clinical presentation, and radiologic features of neurological deficit for pediatric arterial ischemic stroke （PALS）. Methods The medical records of 42 PAlS patients （age range： 9 months to 13 years） treated at Wuhan Children＇s Hospital between July 2007 and January 2011 were retrospectively reviewed. Infarction location was first determined by craniocerebral computed tomography and magnetic resonance （MR） imaging. The stenotic or occluded main cerebral arteries and/or branches were determined by MR angiography and digital subtraction angiography. Results The majority of the 42 PAlS cases （66.7%, n=28） were 〈3 years old （vs. 〉3 years old： 33.3%, n=14; P〈0.05）, but the male： female ratio was similar in both groups （P〉0.05）. The most frequently reported signs and symptoms for both age groups were limited physical activity followed by convulsions and delirium, but convulsions were more prevalent in children 〈3 years-old. Children〉3 years-old mainly experienced the limited physical activity symptoms, including hemiparalysis, aphasia, and ataxia. For all 42 cases, the most frequent etiologies were infections （38.1%, n=16）, iron deficiency anemia （16.7%, n=7）, and moyamoya syndrome （11.9%, n=5）. The predominant infarcts among all cases were middle cerebral artery （63.6%, n=21） and basal ganglia （64.3%, n=27）. Conclusions PAlS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom. The overall etiologies of PAlS may be different from those of adult stroke and the involved regions may be distinguishing features of PAlS or its different forms, but more research is required.展开更多
文摘Background Stroke occurs upon obstruction of cerebral blood circulation and is clinically characterized by sudden onset symptoms. Advanced age is the main risk factor of stroke, but cases of pediatric stroke have been rarely reported. This study aimed to determine the etiology, clinical presentation, and radiologic features of neurological deficit for pediatric arterial ischemic stroke （PALS）. Methods The medical records of 42 PAlS patients （age range： 9 months to 13 years） treated at Wuhan Children＇s Hospital between July 2007 and January 2011 were retrospectively reviewed. Infarction location was first determined by craniocerebral computed tomography and magnetic resonance （MR） imaging. The stenotic or occluded main cerebral arteries and/or branches were determined by MR angiography and digital subtraction angiography. Results The majority of the 42 PAlS cases （66.7%, n=28） were 〈3 years old （vs. 〉3 years old： 33.3%, n=14; P〈0.05）, but the male： female ratio was similar in both groups （P〉0.05）. The most frequently reported signs and symptoms for both age groups were limited physical activity followed by convulsions and delirium, but convulsions were more prevalent in children 〈3 years-old. Children〉3 years-old mainly experienced the limited physical activity symptoms, including hemiparalysis, aphasia, and ataxia. For all 42 cases, the most frequent etiologies were infections （38.1%, n=16）, iron deficiency anemia （16.7%, n=7）, and moyamoya syndrome （11.9%, n=5）. The predominant infarcts among all cases were middle cerebral artery （63.6%, n=21） and basal ganglia （64.3%, n=27）. Conclusions PAlS occurs more frequently in younger children and this group most frequently presents with convulsion as the initial symptom. The overall etiologies of PAlS may be different from those of adult stroke and the involved regions may be distinguishing features of PAlS or its different forms, but more research is required.
