CAJ | 학술논문

目的：分析天津市疑似预防接种异常反应（AEFI）主动监测数据的发生特征，评价同期被动监测系统的敏感性。方法2011—2013年，分层选择4个区县的8家接种门诊作为主动监测点，通过主动回访收集到的AEFI为主动监测AEFI数据，通过全国信息系统收集全市范围自愿就医的被动监测数据。组织AEFI调查诊断专家组对除明确诊断为一般反应以外的AEFI开展调查诊断分类。结果共有效主动监测32698例，AEFI病例235例，发生率为718.70/10万剂。3年间AEFI主动监测发生率差异无统计学意义（849.01/10万剂vs 599.32/10万剂vs 686.72/10万剂，χ2=5.07）；被动监测AEFI 4164例，发生率为34.09/10万剂；3年间AEFI被动监测发生率逐年上升（20.05/10万剂vs 31.35/10万剂vs 50.51/10万剂，χ2=572.02，P<0.05）；各年度主动监测AEFI发生率均高于被动监测（均P<0.05）。主动监测AEFI的一般反应所占比例（95.32%）高于被动监测（85.09%），异常反应低于被动监测（3.83%vs 13.32%，均P<0.05），偶合症、心因性反应差异均无统计学意义。二者均未监测到疫苗质量事故和接种事故，AEFI发生率居前5位的疫苗中均有7价肺炎、麻疹、进口百白破疫苗。结论 AEFI主动监测可发现更多的轻微一般反应，天津市被动监测系统的敏感性逐年上升，能够满足工作需求。应建立针对严重AEFI病例的统一分类诊断标准。
목적：분석천진시의사예방접충이상반응（AEFI）주동감측수거적발생특정，평개동기피동감측계통적민감성。방법2011—2013년，분층선택4개구현적8가접충문진작위주동감측점，통과주동회방수집도적AEFI위주동감측AEFI수거，통과전국신식계통수집전시범위자원취의적피동감측수거。조직AEFI조사진단전가조대제명학진단위일반반응이외적AEFI개전조사진단분류。결과공유효주동감측32698례，AEFI병례235례，발생솔위718.70/10만제。3년간AEFI주동감측발생솔차이무통계학의의（849.01/10만제vs 599.32/10만제vs 686.72/10만제，χ2=5.07）；피동감측AEFI 4164례，발생솔위34.09/10만제；3년간AEFI피동감측발생솔축년상승（20.05/10만제vs 31.35/10만제vs 50.51/10만제，χ2=572.02，P<0.05）；각년도주동감측AEFI발생솔균고우피동감측（균P<0.05）。주동감측AEFI적일반반응소점비례（95.32%）고우피동감측（85.09%），이상반응저우피동감측（3.83%vs 13.32%，균P<0.05），우합증、심인성반응차이균무통계학의의。이자균미감측도역묘질량사고화접충사고，AEFI발생솔거전5위적역묘중균유7개폐염、마진、진구백백파역묘。결론 AEFI주동감측가발현경다적경미일반반응，천진시피동감측계통적민감성축년상승，능구만족공작수구。응건립침대엄중AEFI병례적통일분류진단표준。
Objective To analyze the occurrence features of the active surveillance of adverse events following immu?nization (AEFI) in Tianjin, and evaluate the sensitivity of passive surveillance systems over the same period. Methods The layered eight vaccination clinics of four counties were selected as active surveillance points. The data of active surveillance AEFI were collected through telephone investigation in 2011-2013. The data of passive surveillance was collected through the national AEFI information management system. The descriptive methodology and chi square test were used. Results A total of 235 cases were collected through active surveillance in 2011-2013. The AEFI incidence rate was 718.70 per 100 000 doses,no difference in the incidence between three years(χ2=5.07). A total of 4164 cases were collected through passive sur?veillance. The incidence rate was 34.09 per 100 000 doses,the incidence increased year by year(χ2=572.02,P<0.05). In ac?tive surveillance cases, 95.32%was the common vaccine reaction, 3.83%was the rare vaccine reaction, no serious vaccinereaction. In passive surveillance cases, the common vaccine reaction, the rare vaccine reaction were 85.09%and 13.32%. The serious vaccine reaction was found in 44 cases. Conclusion The more slightly common vaccine reaction can be found by active surveillance. The sensitivity of Tianjin passive surveillance system is increasing year by year, which can meet the requirements for job. The classification and diagnostic criteria of the serious vaccine reaction need to be established.