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目的评价暴露者接种国产狂犬病疫苗4针免疫法的使用安全性。方法对2011-09-01/2012-06-30济南铁路疾控中心门诊的218名暴露后接种国产狂犬病疫苗对象,按3次4针的2-1-1免疫程序法(4针免疫法)、常规5针免疫法,分2组统计疫苗接种后相关安全性指标资料,分析比较4针免疫法与5针免疫法的安全性。结果 4针免疫法102人发生39例接种反应(38.24%),5针免疫法116人发生35例接种反应(30.17%),反应率差别无统计学意义(χ2=1.57,P>0.05)。2组接种对象全身反应以发热和嗜睡为主,发生率为17.24%~26.47%;局部反应以红肿、疼痛较常见,发生率为27.59%~35.29%。这些反应多数症状轻微,不治而愈。4针免疫法中,年龄<20岁组的疫苗反应率高于其他年龄组,体温超过38.6℃的均为10岁以内的儿童;有4例重度反应,反应率为3.92%,需要对症治疗。中度及以上的发热者4针免疫法多于5针免疫法,2组之间的差别具有统计学意义(χ2=6.62,P<0.05)。另外,4针免疫法组疫苗反应持续时间较长(x2=7.60,P<0.05),且以4针法的年龄≥50岁的疫苗反应率较高。结论暴露者接种国产狂犬病疫苗4针与5针免疫法的反应率差异无统计学意义,但对于较小年龄和较大年龄的接种对象,应尽量使用5针免疫法,以避免不良反应的发生,提高疫苗的安全使用。
Objective To evaluate the safety of the 4-needle immunization of vaccines against domestic rabies vaccine. Methods A total of 218 rabies vaccine candidates exposed to Jinan Railway Center for Disease Control and Prevention after 2011-09-01 / 2012-06-30 were vaccinated according to the 2-1-1 immunization protocol (4-needle immunization) , Conventional 5-pin immunization method, divided into 2 groups, the relevant safety index data after vaccination were analyzed, and the safety of 4-needle immunization and 5-needle immunization was compared and analyzed. Results There were 39 inoculation reactions (38.24%) in 102 patients with 4-needle immunization and 35 inoculation reactions (30.17%) in 116 patients with 5-needle immunization. There was no significant difference in response rate between the two groups (χ2 = 1.57, P> 0.05). The incidence of systemic reactions in the two groups was fever and drowsiness, the incidence rate was 17.24% ~ 26.47%. Local reactions were inflamed and the pain was more common, the incidence rate was 27.59% -35.29%. Most of these symptoms are mild and cureless. In the 4-needle immunization method, the vaccine response rate in the group of <20 years old was higher than that in other age groups. The children whose body temperature was over 38.6 ° C were all within 10 years old. There were 4 severe reactions and the response rate was 3.92%, which required symptomatic treatment. Moderate and above fever 4-pin immunization method more than 5-pin immunization, the difference between the two groups was statistically significant (χ2 = 6.62, P <0.05). In addition, the vaccine response of the 4-needle immunization group lasted longer (x2 = 7.60, P <0.05), and the vaccine response rate of the 4-acupuncture group aged ≥50 years was higher. Conclusion There was no significant difference in response rate between 4 rabbits vaccinated with 5 rabbits and 5 rabbits vaccinated rabies vaccine. However, in the vaccinated subjects of younger age and older age, 5-needle immunization should be used to avoid the occurrence of adverse reactions , Improve the safe use of the vaccine.