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目的利用数据发掘技术分析广东省2009~2014年甲型肝炎减毒活疫苗(Hepatitis A Attenuated Live Vaccine,Hep A-L)预防接种异常反应的可疑信号。方法利用比例失衡分析(Disproportionality Analysis,DPA)频数法中的报告比值比(Reporting Odds Ratio,ROR)和比例报告比(Proportional Reporting Ratio,PRR)及贝叶斯法中的贝叶斯置信传播神经网络(Bayesian Confidence Propagation Neural Network,BCPNN)和模糊贝叶斯伽马-泊松收缩论(Empirical Bayes Gamma-Poisson Shrinker,GPS)方法,对广东省2009~2014年疑似预防接种异常反应(AEFI)信息管理系统中报告的有明确诊断的Hep A-L预防接种异常反应进行分析,检测可疑信号。结果广东省2009~2014年有8 233例明确诊断的预防接种异常反应个案参与分析,其中Hep A-L的异常反应169例,占2.05%,使用ROR和PRR分析发现7个可疑信号,使用BCPNN和GPS方法共发现2个可疑信号。4种方法发现的可疑信号主要是接种Hep A-L后过敏性休克和喉头水肿。结论过敏性休克和喉头水肿为已知的Hep A-L的预防接种异常反应,利用DPA方法发现可疑信号增高的警示,需要更严谨的流行病学方法对信号进行评估。
Objective To analyze the suspicious signals of abnormal response to vaccination with Hepatitis A Attenuated Live Vaccine (Hep A-L) from 2009 to 2014 in Guangdong Province by using data mining technology. Methods Using the Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) in the DPA frequency method and the Bayesian belief-based propagation neural network (Bayesian Confidence Propagation Neural Network, BCPNN) and fuzzy Bayesian Gamma-Poisson Shrinker (GPS) methods were used to analyze the information of suspected AEFI in Guangdong from 2009 to 2014 An abnormal diagnosis of Hep AL vaccination with definite diagnosis reported in the system was analyzed to detect suspicious signals. Results A total of 8 233 cases of abnormal diagnosis of vaccination in Guangdong Province from 2009 to 2014 were involved. Among them, 169 cases (2.05%) of abnormal Hep AL were detected. Seven suspicious signals were detected by ROR and PRR, using BCPNN and GPS Methods A total of 2 suspicious signals were found. The suspicious signals found by the four methods were mainly anaphylactic shock and laryngeal edema after Hep A-L inoculation. Conclusions Anaphylactic shock and laryngeal edema are known vaccination anomalous responses to Hep A-L. Using the DPA method to detect increased warnings of suspicious signals requires more rigorous epidemiological methods to evaluate the signal.