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目的研究狂犬病疫苗暴露后“2-1-1”方案的疗效与副反应。方法对2010年1月-2012年12月东南大学附属第二医院急诊符合条件的900例Ⅱ级暴露人群,随机分为两组,其中437例暴露后患者进行“2-1-1”程序免疫,400例暴露后患者常规5针法。“2-1-1”免疫疗法与常规5针法使用鸡胚细胞液体狂犬病疫苗,观察每针注射后的局部副反应和全身副反应,在免疫后7 d、21 d和42 d(全程注射后14 d)用间接免疫荧光法检测抗体水平。结果 “2-1-1”方案与常规5针注射狂犬病疫苗局部副反应分别为15.1%、14.2%,全身副反应发生率分别为19.2%、14.1%,免疫7 d后抗体阳性率分别是71.6%、63.5%,免疫21 d后抗体阳性率分别是94.2%、90.5%,免疫42 d后抗体阳性率分别为97.5%、98.3%。结论 “2-1-1”免疫程序早期全身反应多于常规注射方式,但接种次数减少,抗体阳性率早于常规注射产生,两种免疫方案总体疗效相当。
Objective To study the efficacy and side effects of “2-1-1” after rabies vaccine exposure. Methods Nine hundred and ninety-two stage Ⅱ exposed patients in the emergency department of the Second Affiliated Hospital of Southeast University from January 2010 to December 2012 were randomly divided into two groups, of which 437 were exposed to “2-1-1” Procedural immunity, 400 patients after exposure to conventional 5-pin method. “2-1-1 ” immunotherapy and conventional 5-pin method using chicken embryo liquid rabies vaccine to observe the local side effects and systemic side effects after injection of each injection, at 7 d, 21 d and 42 d after immunization ( The whole injection 14 d) using indirect immunofluorescence assay antibody levels. Results The local side effects of “2-1-1” regimen and conventional 5-needle injection rabies vaccine were 15.1% and 14.2% respectively, and the incidences of systemic side effects were 19.2% and 14.1% respectively. After 7 days of immunization, the positive rates of antibodies were respectively The antibody positive rates after immunization for 21 days were 94.2% and 90.5% respectively. The positive rates of antibody after immunization for 42 days were 97.5% and 98.3% respectively. Conclusion The early stage of systemic immune response to “2-1-1” immunization procedure is more than the conventional injection method, but the frequency of inoculation is reduced and the positive rate of antibody is earlier than that of conventional injection. The overall efficacy of the two immunization programs is quite similar.