两种狂犬病疫苗联合人狂犬病免疫球蛋白的效果分析

目的 了解高州市犬伤重伤暴露人群注射冻干和液体人用狂犬病疫苗及联合注射人狂犬病免疫球蛋白的效果。方法 调查对象为2005年8月1日～2006年11月30日到高州市疾控中心就诊的犬伤重伤者（全为Ⅲ级伤）。狂苗用7针法（0、3、7、14、28d，第一第二针次加注1支）和5针法联合注射人狂犬病免疫球蛋白，全程免疫后第30d用酶联免疫法检测血清抗体水平，联合使用武汉生物制药研究所生产的人狂犬免疫球蛋白（批号20050702-1，生产日期20050501，有效期20080817），剂量为20IU／Kg体重，治疗中观察副反应。结果 狂苗免疫抗体阳性率达到99．13％（574／579），不同程度的反应率为3．45％（20／579），579人中注射冻干狂苗7针法361人，抗体阳性率（360／361）99．72％，副反应为（5／361）1．38％，注射液体狂苗7针法59人，抗体阳性率（59／59）100％，副反应为（7／59）11．86％，注射液体狂苗5针法159人，抗体阳性率（155／159）97．48％，副反应为（12／159）7．5％，无中强反应发生。人狂犬病免疫球蛋白对伤口有抗感染、促进结痂、愈合作用。经设对照组比较，实验组平均结痂时间较对照组早2．43d，愈合时间早0．94d。结论 冻干人用狂犬病疫苗7针法及联合应用人狂犬病免疫球蛋白治疗安全，副作用少，保护率高；狂犬病免疫球蛋白对伤口有促进伤口结痂、愈合作用。

Clinical observation on the effect of injection of lyophilized rabies vaccine and human rabies immunoglobulin on patients bitten by dogs

Objective To assess the protective effect of combined use of lyophilized and liqid human anti-rabies vaccines plus human rabies immunoglobulin on patients severely bitten by dogs in Gaozhou City. Methods The patients severly bitten by dogs from August 2005 to November 2006 were surveyed.Each patients reveived 7 injections of human anti-rabies immunoglobulin with a dose of 20IU/kg each time and any side effects during treatment was recorded.The levels of serum antiboy was tested with ELISA on d30 after the vaccination was completed. Results The positive rate of antibody in the treatment group was 99.72%(360/361) and the adversary reaction rate was 1.38%(5/361).The average scabbing time and wound healing time in the treatment group were 2.43 days and 0.94 day early than that of the control group. Conclusion The 7 injections of lyophilized human rabies vaccine incobination with huamn anti-rabies immunoglobulin is safe with high protectiverate and less side effects.The anit-rebies immunoglobulin can promote the scabbing and healing of the wound.