文献类型：期刊文献

中文题名：预防接种异常反应监测中的偶合现象:对1例血小板减少病例的深入分析

英文题名：Coupling Phenomena in the Monitoring of Abnormal Vaccination Reactions:An In-Depth Analysis of a Case ofThrombocytopenia

作者：代晶晶[1];梁雪枫[2];卢玉俊[1];李苗苗[1];孙彩萍[1]

第一作者：代晶晶

机构：[1]甘肃中医药大学附属医院,甘肃兰州730020;[2]甘肃省疾病预防控制中心,甘肃兰州730020

第一机构：甘肃中医药大学第二附属医院

年份：2026

卷号：40

期号：2

起止页码：112

中文期刊名：中国初级卫生保健

外文期刊名：Chinese Primary Health Care

基金：甘肃省卫生健康行业科研项目(科研计划GSWSKY2023-21);糖脂代谢病教育部重点实验室开放课题基金;国家科技部重点研发计划中医药现代化专项(2023YFC3606200)。

语种：中文

中文关键词：乙型脑炎减毒活疫苗;麻腮风联合减毒活疫苗;血小板减少;偶合反应

外文关键词：live attenuated Japanese encephalitis vaccine;combined live attenuated MMR vaccine;thrombocytopenia;coincidental reaction

摘要：目的:明确1例患儿接种乙型脑炎减毒活疫苗(JE)、麻腮风减毒活疫苗(MMR)后发现的血小板减少是否与接种有关,对疑似预防接种异常反应(AEFI)进行判断。方法:采用个体调查的方法,收集了患儿出生档案及入院病历、疫苗生产企业的合格证、疫苗批批质量检验报告、接种站操作规程等资料;并将资料递交到市级专家调查诊断组(具有血液、流行病、儿科学等专业人员),依据《预防接种不良反应判定原则》综合分析、形成结论。结果:接种过JE、MMR疫苗儿童于2025年2月14日完成2剂次接种后进行30 min留观,无不适;并于次日起直至2月17日因血小板减少入院治疗,以“血小板减少、呼吸系统疾病急性期”作为出院诊断。调查结果显示,此批疫苗产品质量合格,整个接种过程均按照《预防接种工作规范》要求操作。市级专家组对此作出的事实判断结论为不属于预防接种反应。结论:该儿童的血小板减少症状与疫苗接种无因果关联,属于偶合反应,提示临床需注意疫苗接种后偶合疾病的鉴别诊断。
OBJECTIVE To determine whether thrombocytopenia observed in a pediatric patient following administration of JE(Japanese Encephalitis)live attenuated vaccine and MMR(Measles,Mumps,Rubella)live attenuated vaccine was vaccine-related and to assess for suspected adverse events following immunization(AEFI).METHODS An individual case investigation was conducted.Data collected included the patient’s birth records,admission medical records,vaccine manufacturer’s certificate of conformity,batch-specific vaccine quality inspection reports,and vaccination station operating procedures.These materials were submitted to the municipal ADR expert investigation and diagnosis team(comprising specialists in hematology,epidemiology,pediatrics,etc.).A comprehensive analysis was performed based on the Principles for Determining Adverse Reactions to Immunization to reach a conclusion.RESULTS The child,who had received JE and MMR vaccines,completed two doses on February 14,2025,and underwent a 30-minute observation period without adverse reactions.The child was admitted for treatment starting the following day until February 17 due to thrombocytopenia,with the discharge diagnosis being“thrombocytopenia and acute phase of respiratory disease”.The investigation confirmed that the vaccine batch met quality standards and that all vaccination procedures strictly adhered to the Standard Operating Procedures for Immunization.The municipal expert panel concluded that this case did not constitute a vaccine-related adverse reaction.CONCLUSION The child’s thrombocytopenia was not causally linked to vaccination and represented a coincidental reaction.This highlights the clinical need for differential diagnosis of coincidental illnesses following vaccination.