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目的了解麻疹减毒活疫苗(Measles Attenuated Live Vaccine,MV)疑似预防接种异常反应(Adverse Events Following Immunization,AEFI)的特点,为AEFI监测、调查诊断和处理提供参考。方法计算机检索中国医院知识数据库(1994～2010年)和万方数据库(1993～2010年)报道的MVAEFI文献,从合格文献中提取相关信息进行分析。结果通过检索和筛选共获得文献73篇,包括案例88例。2007～2010年的年发表量均≥8篇。88例个案中,58%为男性。53%的案例发生在接种后≤1d,75%发生在接种后≤3d;38%的案例发生在接种第1剂后。临床损害中过敏性紫癜30例,过敏性皮疹10例,脑炎9例,麻疹8例。发生原因中,异常反应60例(其中51例为过敏反应),偶合症23例。病例77%治愈;47%的病例病程>2周。88例个案中,33例医院诊断,43例疾病预防控制中心诊断,12例由预防接种异常反应诊断小组诊断。结论 MVAEFI主要以异常反应报道最多,异常反应中又以过敏反应最多。应加强预防接种人员和临床医生的相关知识培训,规范AEFI的诊断和处置,尽量减少病人的病程和相关纠纷的产生。
Objective To understand the characteristics of measles attenuated live vaccines (AEFI) and to provide a reference for AEFI monitoring, investigation, diagnosis and treatment. Methods The MVAEFI literature reported by Chinese Hospital Knowledge Database (1994-2010) and Wanfang Database (1993-2010) was retrieved by computer. Relevant information was extracted from qualified documents for analysis. Results A total of 73 articles were obtained through searching and screening, including 88 cases. The annual published volume from 2007 to 2010 was ≥8. Of the 88 cases, 58% were male. Fifty-three percent of cases occurred ≤1 days after inoculation, 75% occurred ≤3 days after vaccination, and 38% occurred after the first dose. 30 cases of allergic purpura in clinical damage, allergic rash in 10 cases, 9 cases of encephalitis, 8 cases of measles. Occurrence of the reasons, the abnormal reaction in 60 cases (51 cases of allergic reactions), 23 cases of coupling. 77% of cases were cured; 47% of cases were> 2 weeks. Among the 88 cases, 33 were diagnosed by the hospital, 43 were diagnosed by the Centers for Disease Control and Prevention, and 12 were diagnosed by the diagnostic team for the prevention of vaccination abnormalities. Conclusions MVAEFI is mainly reported by abnormal reaction and allergic reaction by abnormal reaction. Should strengthen the vaccination staff and clinicians related knowledge training, standardize the diagnosis and treatment of AEFI, minimize the patient’s course and related disputes.