中国狂犬病疫苗不良反应发生率Meta分析

张晓蕊; 武治国; 张文生

Abstract

张晓蕊,武治国,张文生.中国狂犬病疫苗不良反应发生率Meta分析[J].Chinese journal of Epidemiology,2017,38(6):821-827

中国狂犬病疫苗不良反应发生率Meta分析

Adverse reaction caused by rabies vaccine in China:a Meta-analysis

Received:November 29, 2016

DOI：10.3760/cma.j.issn.0254-6450.2017.06.026

KeyWord: 狂犬病疫苗不良反应 Meta分析

English Key Word: Rabies vaccine Adverse reaction Meta-analysis

FundProject:

Author Name	Affiliation	E-mail
Zhang Xiaorui	Preventive Medicine Outpatient Department, Tianjin Provincial Center for Disease Control and Prevention, Tianjin 300011, China
Wu Zhiguo	Preventive Medicine Outpatient Department, Tianjin Provincial Center for Disease Control and Prevention, Tianjin 300011, China
Zhang Wensheng	Preventive Medicine Outpatient Department, Tianjin Provincial Center for Disease Control and Prevention, Tianjin 300011, China	zws.202@163.com

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Abstract:

目的对中国地区狂犬病暴露后的普通人群全程接种狂犬病疫苗后不良反应发生率进行Meta分析，为开展狂犬病疫苗接种策略改进提供数据支持。方法计算机检索中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、中国生物医学文献服务系统、PubMed英文数据库和The Cochrane Library中公开发表的有关狂犬病疫苗接种后不良反应的研究文献，检索时限为2000年1月至2016年7月，根据纳入和排除标准收集资料，采用R软件对狂犬病疫苗不良反应发生率进行Meta分析。结果共纳入29篇文献，纳入文献无明显发表偏倚，其中总调查人数为94 222人，发生不良反应11 020例，不良反应发生率为1.04%～47.78%。狂犬病疫苗总不良反应的合并发生率为9.82%（95% CI：7.58%～12.72%），局部不良反应的合并发生率为12.05%（95% CI：9.26%～15.69%），全身不良反应的合并发生率为9.06%（95% CI：7.07%～11.61%）。液体疫苗接种不良反应合并率为32.39%（95% CI：21.88%～47.94%），冻干疫苗接种不良反应合并率为8.65%（95% CI：4.54%～16.51%），两组差异有统计学意义（P<0.05）。结论狂犬病疫苗接种局部不良反应率高于全身不良反应率。液体狂犬病疫苗不良反应率高于冻干狂犬病疫苗，建议采用安全性较好的冻干狂犬病疫苗，逐步替代液体狂犬病疫苗。

English Abstract:

Objective To conduct a Meta-analysis on the rate of adverse reaction related to rabies vaccine, so as to provide reference for rabies vaccine immunization in China. Methods We electronically searched databases including CNKI, VIP information resource integration service platform, WanFang Data, CBM, PubMed and The Cochrane Library, to collect studies on Chinese people who had received full rabies vaccination and recording all the adverse reactions, from January 2000 to July 2016. Inclusion and exclusion criteria were strictly followed. Meta-analysis for the adverse reaction rate was performed using the R software. Results A total of 29 related papers had met the inclusion criteria, with no publication bias noticed. A total number of 11 020 cases had adverse reactions, among all the 94 222 respondents, with an incidence of adverse reactions as 1.04%-47.78%. The overall incidence rate of adverse reaction was 9.82% (95%CI:7.58%-12.72%). A combined local adverse reaction rate appeared as 12.05% (95%CI:9.26%-15.69%). The systemic adverse reaction rate was 9.06% (95%CI:7.07%-11.61%). The overall adverse reaction rate on aqueous vaccine was 32.39% (95%CI:21.88%-47.94%). Combined adverse reaction rate of freeze dried vaccine appeared as 8.65% (95%CI:4.54%-16.51%). Significant differences were seen between both groups (P<0.05). Conclusions The local adverse reaction rate caused by rabies vaccination was higher than the systemic adverse reaction rate. The adverse reaction rate of aqueous rabies vaccine was higher than that of freeze dried rabies vaccine. Our results suggested that the aqueous vaccine should gradually be eliminated.

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