摘要
目的调查1例病例接种1剂次脊髓灰质炎灭活疫苗(inactivated poliovirus vaccine,IPV)、2剂次脊髓灰质炎减毒活疫苗(bivalent oral poliovirus vaccine,bOPV)与发生急性弛缓性麻痹(acute flaccid paralysis,AFP)事件之间的关联性。方法个案调查阶段,资料收集疫苗受种方、接种方以及疫苗生产企业资料。市、县两级预防接种异常反应(adverse events following immunization,AEF1)调查诊断专家组提出诊断意见。结果该病例先后接种多种疫苗,其中接种第1剂次IPV时间为2017年2月22日,接种2剂次bOPV时间分别为2017年3月23日、4月23日。于2018年12月21日开始发病,出现右上肢、左下肢麻痹症状,先后在县级、省级医院就诊,主要诊断为AFP。大便标本无病毒检出。T淋巴细胞亚群检测结果正常。预防接种过程符合操作规程,疫苗质量合格。市、县两级AEFI调查诊断专家组现场体检,右上肢近端肌力、远端肌力分别为Ⅰ级、Ⅱ级,左下肢近端肌力、远端肌力分别为IV-级、IV+级,右上肢、左下肢近端肌肉均明显萎缩、肌张力低,左下肢略外旋。调查诊断意见为不属于疫苗接种异常反应。结论该病例所接种的疫苗与其发生AFP症状无关联。
Objective To investigate the relationship among vaccination of one dose of inactivated poliovirus vaccine(IPV),two doses of bivalent oral poliovirus vaccine(bOPV)and the events of acute flaccid paralysis(AFP)in a given case.Methods In the period of case investigation,the data of vaccine administration,vaccination and the information of vaccine manufacturers were collected.The expert group of county and municipal level for the investigation of rare vaccine reactions put forward diagnostic advice.Results The patient was inoculated with multiple vaccines successively.The first dose of IPV was given on February 22,2017,the two doses of bOPV were given on March 23,2017,and on April 23,2017 respectively.The disease occured on December 21,2018 with symptoms of paralysis on the right upper limb and left lower limb in the patient.The patient was treated in a county and provincial hospitals successively.The disease was mainly diagnosed as AFP peripheral paralysis).No virus was detected in stool specimens.And the results of T lymphocyte subsets were normal.The inoculation conformed to the operating procedures,and the quality of the vaccines was qualified.The expert group of county and municipal level for the AEFI investigation carried out filed inspection and found that the proximal muscle force of right upper limbs wasⅠlevel and its distal muscle force wasⅡlevel,and the proximal and distal muscle force of the left lower limbs were IV-level and IV+level respectively.The proximal muscles of the right upper limb and the left lower limb were obviously atrophic with low muscle tone,and the left lower limb was slightly rotated outward.The opinion of the investigation and diagnosis was that the AFP disease did not belong to Rare Vaccine Reaction(RVR).Conclusion The vaccine administration in this case is not associated with AFP symptoms.
作者
沙娜
王文祥
马敬仓
刘景顺
徐凌忠
SHA Na;WANG Wenxiang;MA Jingcang;LIU Jingshun;XU Lingzhong(Jining First People's Hospital,Shandong 272000,China;不详)
出处
《医学动物防制》
2020年第5期414-417,共4页
Journal of Medical Pest Control
基金
国家自然科学基金委员会面上项目(71673169)。
