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皮内注射卡介苗接种效果的评价
引用本文:康万里,凌颖,徐苗,赵爱华,都伟欣,陈鸣,高铁杰,张治国,胡代玉,冯先惠,郭菁,张海霞,何菊,刘冠,李海英,吴新悦,王翠芝,郑素华,王国治. 皮内注射卡介苗接种效果的评价[J]. 中国防痨杂志, 2014, 0(4): 248-252
作者姓名:康万里  凌颖  徐苗  赵爱华  都伟欣  陈鸣  高铁杰  张治国  胡代玉  冯先惠  郭菁  张海霞  何菊  刘冠  李海英  吴新悦  王翠芝  郑素华  王国治
作者单位:[1]北京市结核病胸部肿瘤研究所首都医科大学附属北京胸科医院,101149 [2]中国食品药品检定研究院 ,101149 [3]江苏省常州市疾病预防控制中心 ,101149 [4]北京市昌平区结核病防治所 ,101149 [5]重庆市结核病防治所 ,101149 [6]北京市海淀区疾病预防控制中心 ,101149 [7]成都生物制品研究所,101149
基金项目:“十二五”国家科技重大专项(2012ZXl0004701)
摘    要:目的研究卡介苗接种效果及可能的影响因素。方法采用多中心、无对照、开放式、前瞻性队列研究,选取我国北京市、江苏省和重庆市的4个区(市)出生3个月内的婴儿或PPD试验阴性儿童(〈1岁)为研究对象,总共纳入研究对象27517例,评价卡介苗接种效果和研究可能影响卡介苗接种效果的因素。结果(1)卡介苗接种卡痕均径中位数4.50mm,四分位数3.50~5.00mm。卡痕均径〈1mm223例(0.81%,223/27517),卡痕均径≥1mm27294例(99.19%,27294/27517);(2)PPD硬结均径中位数8.50mm,四分位数6.50~11.00mm。PPD硬结均径95mm26838例(97.53%,26838/27517);PPD硬结均径〈5mm679例(2.47%,679/27517);(3)城镇医疗机构PPD阴性率(2.28%,571/25004)低于乡村(4.30%,108/2513)(X2=38.487,P(0.001);三级医院PPD阴性率(4.18%,199/4760)较一级医疗机构(3.22%,217/6733)、二级医疗机构(1.64oS,263/16024)高(X2=119.464,P(0.001);北京市PPD阴性率(0.53%,57/10679)较江苏省(4.15%,383/9239)、重庆市(3.15%,239/7599)低(X2=288.511,P(0.001);(4)本研究共发生不良反应19例,不良反应发生率为6.90/万。不同省(直辖市)卡介苗不良反应率[北京市0,江苏省19.48/万(18/9239),重庆市1.32/万(1/7599)]差异有统计学意义(X2=32.005,P〈0.001)。结论卡介苗接种效果可能与城乡差别、医院级别、地区等因素有关;应加强卡介苗接种监测,尽力提高卡介苗接种成功率。

关 键 词:结核  预防和控制  卡介苗  接种  注射,皮内

Study on the efficacy of BCG vaccine for intradermal injection
KANG Wan-li,LING Ying,XU Miao,ZHAO Ai-hua,DU Wei-xin,CHEN Ming,GAO Tie-fie,ZHANG Zhi-guo,HU Dai-yu,FENG Xian-hui,GUO Jing,ZHANG Hai-xia,HE Ju,LIU Guan,LI Hai-ying,WU Xin-yue,WANG Cui-zhi,ZHENG Su-hua,WANG Guo- zhi. Study on the efficacy of BCG vaccine for intradermal injection[J]. The Journal of The Chinese Antituberculosis Association, 2014, 0(4): 248-252
Authors:KANG Wan-li  LING Ying  XU Miao  ZHAO Ai-hua  DU Wei-xin  CHEN Ming  GAO Tie-fie  ZHANG Zhi-guo  HU Dai-yu  FENG Xian-hui  GUO Jing  ZHANG Hai-xia  HE Ju  LIU Guan  LI Hai-ying  WU Xin-yue  WANG Cui-zhi  ZHENG Su-hua  WANG Guo- zhi
Affiliation:, Email : tbtestlab@ 163. net
Abstract:Objective To study the immune efficacy and the influencing factors of BCG. Methods Multi- center, no control, open, prospective cohort study was used to select the study population. The effect and influen- cing factors of BCG were studied for the baby (〈3 months) or the children (〈1 years old) PPD negative in 4 dis- tricts (city) in Beijing, Jiangsu and Chongqing. The qualified study population was 27 517. Results (1) The me- dian of BCG scar was 4.50 mm, the quartile of BCG scar was 3.50--5.00 mm. The BCG scar ≥1 mm was 223 (0.81~, 223/27 517) and ≥1 mm 27 294(99.19%, 27 294/27 517). (2)The median of PPD was 8.50 ram, the quartile was 6.50--11.00 mm. The positive reaction was 26 838(97.53%, 26 838/27 517) and the negative reaction 679(2.47%, 679/27 517). (3) The negative rate of PPD was lower in urban(2.28% ,571/25 004)than rural hospi- tals(4. 30%, 108/2513) X2=38. 487, P〈0. 001). The negative rate of PPD was higher in tertiary hospital(4. 18%, 199/4760)than others (X2= 119. 464, P〈0. 001). The negative rate of PPD was lower in Beijing(0. 53%, 57/10 679) than others areaX2 =288. 511, P〈0. 001). (4) There was 19 cases adverse reaction in the study, the rate of ad- verse reaction of BCG was 6.90/10 000. The rate of adverse reaction of BCG was different in the three provinces (X2 =32. 005, P〈0. 001). Conclusion The effect of BCG may be related with urban-rural difference, hospitallevel, area, et al. The monitoring of ~ vaccine effect should be strengthened. The effect of BCG vaccine should be improved in order to control the tuberculous meningitis and TB.
Keywords:Tuberculosis/prevention control  BCG vaccine  Vaccination  Injections, intradermaI
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