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目的加强对接种疫苗出现的不良反应进行监测,总结和评估不同疫苗引起紫癜的临床特征、诊断要点、治疗原则及应对措施。方法对1994~2005年报道的3类预防接种引起紫癜156例进行回顾性流行病学调查。结果156例紫癜的年龄为8日龄~46岁,首发时间为接种疫苗后1h~15d,除1例死亡外,其余均治愈,治疗时间为5d~6个月。3类预防接种方式中,麻疹减毒活疫苗等8种预防接种既可以引起血小板减少性紫癜,也可引起过敏性紫癜,有时还会并发紫癜性肾炎、关节性紫癜等;麻疹-流行性腮腺炎-风疹联合减毒活疫苗等4种预防接种一般只引起血小板减少性紫癜;脑膜炎球菌多糖疫苗等9种预防接种一般只引起过敏性紫癜。结论预防接种后发生紫癜的原因与受种者自身体质、接种当时体质、疫苗质量、疫苗联合免疫方式等可能有关。
Objective To strengthen the monitoring of adverse reactions to vaccination and to summarize and evaluate the clinical characteristics, diagnosis points, treatment principles and countermeasures of purpura caused by different vaccines. Methods A retrospective epidemiological investigation was performed on 156 cases of purpura caused by three types of vaccinations reported from 1994 to 2005. Results The age of 156 purpura patients ranged from 8 days to 46 years. The starting time was 1 h to 15 d after vaccination. Except for 1 case, the other cases were cured. The treatment time ranged from 5 days to 6 months. Three types of immunization, measles attenuated live vaccine and other 8 kinds of vaccination can cause thrombocytopenic purpura can also cause allergic purpura, and sometimes complicated by purpura nephritis, joint purpura, etc .; measles - epidemic parotid gland Inflammation - rubella joint live attenuated attenuated vaccine and other four kinds of vaccination generally cause only thrombocytopenic purpura; meningococcal polysaccharide vaccine and other nine kinds of vaccination generally cause allergic purpura. Conclusion The causes of purpura after vaccination may be related to the physical constitution of the recipient, the constitution at the time of inoculation, the quality of the vaccine and the way of combined immunization of the vaccine.