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目的了解乙型肝炎疫苗(Hepatitis B Vaccine,HepB)预防接种异常反应(Adverse Events Following Immu-nization,AEFI)发生的特点和规律,为异常反应的鉴定和处理提供参考。方法采用系统评价的方法,全面检索中国医院知识数据库(1994~2007年)和万方数据库(1993~2007年),对获得文献进行质量评价,从合格文献中提取相关信息进行分析。结果共纳入36种杂志的文献48篇,58例。66.67%的文献来自县、市级医院和疾病预防控制中心。报道的HepB异常反应中,居前4位的是过敏性休克、过敏性皮疹、过敏性紫癜、局部过敏反应。接种HepB后<24h发生的异常反应占案例总数的75.86%,第1剂接种后发生的异常反应占案例总数的58.62%。结论HepB性质稳定,异常反应发生的概率低。报道的相关文献中,属于异常反应的文献占57.14%。临床医生在异常反应处理中意义重大,应在医生群体中加强培训,以便及时发现并合理处理HepB预防接种异常反应。
Objective To investigate the characteristics and rules of Hepatitis B Vaccine (HepB) for prevention of abnormal immune response (AEFI) and to provide references for the identification and treatment of abnormal reactions. Methods A systematic review was conducted to comprehensively search the Chinese hospital knowledge database (1994-2007) and Wanfang database (1993-2007), evaluate the quality of the obtained documents, and extract relevant information from qualified documents for analysis. Results A total of 48 articles were included in 36 magazines, 58 cases. 66.67% of the documents come from counties, municipal hospitals and CDC. HepB reported anomalous reactions, the top 4 is anaphylactic shock, allergic rash, Henoch-Schonlein purpura, local allergic reactions. Abnormal reactions occurred in 24h after inoculation of HepB accounted for 75.86% of the total cases, and the first case after inoculation accounted for 58.62% of the total cases. Conclusion HepB is stable in nature with low probability of abnormal reaction. Among the reported articles, 57.14% belong to the literature of abnormal reaction. Clinicians in the treatment of abnormal response of great significance, should be strengthened in the medical community training, in order to timely detection and rational treatment of HepB vaccination abnormalities.