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狂犬病暴露后预防的不良反应:两种不同方案和两种疫苗的比较研究。

Adverse events following rabies post-exposure prophylaxis: a comparative study of two different schedules and two vaccines.

机构信息

Ankara Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.

Guven Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Ankara, Turkey.

出版信息

Travel Med Infect Dis. 2014 Nov-Dec;12(6 Pt A):659-66. doi: 10.1016/j.tmaid.2014.03.004. Epub 2014 Mar 18.

Abstract

OBJECTIVE

Due to lack of effective treatment for rabies, post-exposure prophylaxis becomes very important. In this study, we investigated side effects developed in patients following administration of rabies post-exposure prophylaxis.

METHODS

A total of 1685 patients were vaccinated. 265 patients (15.7%) administered the Essen regimen with equine rabies immunoglobulin and 1420 patients (84.2%) administered Zagreb regimen. 761 (45.2%) patients were vaccinated with a verocell vaccine; Verorab and 924 patients (54.8%) were vaccinated with Abhayrab.

RESULTS

All side effects were higher in female patients than those of males. The patients with chronic illness also had significantly, increased side effects; headache (12.4%), pain at site of administration (11.3%), and arthralgia (10.5%) compared to the patients without chronic illness. We grouped the patients in three as; 0-15 years, 15-60 years, and 60 years and above. In the first group; fever (21.2%), vomiting (2.4%) and coughing (2.1%); in the second group (15-60 years), headache (8.8%), arthralgia (6.7%) were significantly increased compared to the other groups. Side effects are significantly higher with schema of 2-1-1 and Abhayrab trade mark vaccine, particularly following the first doses.

DISCUSSION

Second generation rabies vaccines are safe, effective and cheaper than HDCV. When fatality of rabies disease is considered, occurring side effects can be tolerated.

摘要

目的

由于目前尚无有效的狂犬病治疗方法,暴露后预防就显得尤为重要。本研究旨在探讨狂犬病暴露后预防患者的不良反应。

方法

共 1685 例患者接受了疫苗接种。265 例(15.7%)患者采用马源狂犬病免疫球蛋白联合埃森方案,1420 例(84.2%)患者采用萨格勒布方案。761 例(45.2%)患者接种vero 细胞疫苗;Verorab,924 例(54.8%)患者接种 Abhayrab。

结果

女性患者的所有不良反应发生率均高于男性。患有慢性病的患者也显著增加了不良反应发生率;头痛(12.4%)、注射部位疼痛(11.3%)和关节痛(10.5%)高于无慢性病的患者。我们将患者分为三组:0-15 岁、15-60 岁和 60 岁以上。第一组患者的不良反应发生率为:发热(21.2%)、呕吐(2.4%)和咳嗽(2.1%);第二组(15-60 岁)患者的头痛(8.8%)和关节痛(6.7%)显著高于其他两组。2-1-1 方案和 Abhayrab 商标疫苗的不良反应发生率较高,尤其是在首剂接种后。

讨论

第二代狂犬病疫苗比 HDCV 更安全、有效且更便宜。考虑到狂犬病的致死率,这些不良反应是可以耐受的。

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