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目的分析天津市2011-2013年疑似预防接种异常反应(Adverse Event Following Immunization,AEFI)的发生特征,分析AEFI分类诊断情况及预防接种安全性。方法通过中国AEFI信息管理系统,收集天津市2011-2013年发生的AEFI个案数据,通过天津市免疫规划信息管理系统收集2011-2013年度各种疫苗的接种数据。采用描述流行病学和卡方检验方法进行分析。结果天津市2011-2013年共监测到AEFI 4 164例,3年报告发生率为20.05/10万、31.35/10万、50.51/10万(χ2=560.57,P<0.05)。以发热/红肿/硬结为主的一般反应占85.09%,过敏性皮疹为主的异常反应占13.32%,异常反应报告发生率波动在4/10万~5/10万之间(χ2=5.86,P>0.05)。严重AEFI 44例,报告发生率为0.36/10万,热性惊厥0.17/10万,血小板减少性紫癜0.10/10万,其他严重反应均在0.10/10万以下。结论天津市AEFI报告发生率逐年上升趋势与一般反应监测敏感性增加有关,异常反应报告发生率基本平稳。应加强分类诊断工作,尤其是严重异常反应。建议在全国范围内统一分类诊断标准,确保结论的科学、公正。
Objective To analyze the occurrence characteristics of Adverse Event Following Immunization (AEFI) in Tianjin from 2011 to 2013 and analyze the classification and diagnosis of AEFI and the vaccination safety. Methods The data of AEFI cases in Tianjin from 2011 to 2013 were collected through the Chinese AEFI information management system and the vaccination data of various vaccines in 2011-2013 were collected through Tianjin Immunization Planning Information Management System. Descriptive epidemiological and chi-square test methods were used for analysis. Results A total of 4 164 AEFI cases were detected in Tianjin during 2011-2013. The incidence of 3-year reports was 20.05 / 100000, 31.35 / 100000, 50.51 / 100000 (χ2 = 560.57, P <0.05). The common reactions with fever / redness / induration accounted for 85.09%, allergic rashes accounted for 13.32% of the abnormal reactions, and the incidence of abnormal reaction reports fluctuated between 4/10 and 5/10 million (χ2 = 5.86, P> 0.05). Serious AEFI 44 cases, the report was 0.36 / 100,000, febrile seizures 0.17 / 100,000, thrombocytopenic purpura 0.10 / 100,000, other serious reactions are below 0.10 / 100000. Conclusion The increasing trend of AEFI report in Tianjin is related to the increase of general reaction monitoring sensitivity. The incidence of abnormal response report is basically stable. Should strengthen the classification of diagnostic work, especially serious abnormal reaction. It is suggested that a unified classification of diagnostic criteria across the country to ensure that the conclusions of the scientific and fair.