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Article(id=1241036338754016207, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202503495, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1742832000000, receivedDateStr=2025-03-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815720498, onlineDateStr=2026-03-18, pubDate=1757433600000, pubDateStr=2025-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815720498, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815720498, creator=13701087609, updateTime=1773815720498, updator=13701087609, issue=Issue{id=1241036327177744706, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='17', pageStart='3073', pageEnd='3264', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815717738, creator=13701087609, updateTime=1773840080282, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241138511152206262, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241138511152206263, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3235, endPage=3239, ext={EN=ArticleExt(id=1241036340356239371, articleId=1241036338754016207, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of adverse reactions of 523 individuals aged ≥50 years who received recombinant herpes zoster vaccine, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the incidence of adverse reactions of recombinant zoster vaccine (RZV) in people≥50 years, and to provide reference for RZV vaccination.

Methods

The data of 523 patients who received RZV in the outpatient department of Guizhou Center for Disease Control and Prevention from September 2021 to September 2023 were analyzed.

Results

A total of 523 patients were inoculated with the RZV and the overall incidence of adverse reactions was 50.10%. The incidence of adverse reactions was 63.22% in the 50-59 age group, 40.72% in the 60-69 group, and 26.47% in those aged ≥70 years. Among females and males, the incidence was 44.88% and 61.73%, respectively. The incidence was 61.27% in underweight individuals, 46.59% in those with normal weight, and 30.00% in those who were overweight or obese. Patients with a history of endocrine disease, cardiovascular disease, and shingles showed incidences of 70.83%, 63.72%, and 53.85%, respectively.

Conclusion

The incidence of adverse reactions following RZV vaccination in individuals ≥50 years in Guiyang is relatively low, and most adverse reactions are mild. The incidence rate is influenced by factors such as age, gender, weight, and the presence of underlying diseases. Post-vaccination monitoring and treatment following RZV administration should be tailored to each individual.

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目的

了解重组带状疱疹疫苗(recombinant zoster vaccine, RZV )用于≥50岁人群的不良反应发生率,为RZV的接种提供参考。

方法

2021年9月—2023年9月对贵州省疾病预防控制中心门诊部接种RZV的523例接种者数据进行分析。

结果

接种RZV的523例接种者中总的不良反应发生率50.10%，其中50～59岁、60～69岁及≥70岁的人群不良反应发生率分别为63.22%、40.72%、26.47%；女性、男性人群不良反应发生率分别为44.88%、61.73%；消瘦、正常、超重/肥胖的人群不良反应发生率分别为61.27%、46.59%、30.00%；有内分泌病史、心血管病史、带状疱疹病史的人群不良反应发生率分别为70.83%、63.72%、53.85%。

结论

贵阳≥50岁人群接种RZV不良反应发生率较低、多为轻症；发生率与年龄、性别、体重以及是否有基础疾病等存在差异，要因人而异做好RZV接种后的监测和处置。

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黄梅，E-mail:
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张飞雪（1973—），女，本科，主任医师，研究方向：妇幼卫生

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张飞雪（1973—），女，本科，主任医师，研究方向：妇幼卫生

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张飞雪（1973—），女，本科，主任医师，研究方向：妇幼卫生

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Nature Medicine, 2010, 16(11): 1267-1276., articleTitle=Interactions between the immune and nervous systems in pain, refAbstract=null)], funds=[Fund(id=1241139378240680238, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, awardId=gzwkj2023-072, language=CN, fundingSource=贵州省卫生健康委科学技术基金项目(gzwkj2023-072), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241139373933129754, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, xref=null, ext=[AuthorCompanyExt(id=1241139373949906974, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, companyId=1241139373933129754, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Guizhou Center for Disease Control and Prevention, Guizhou Academy of Public Heath and Preventive Medicine, Guiyang,Guizhou 550004, China), AuthorCompanyExt(id=1241139373958295584, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, companyId=1241139373933129754, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=贵州省疾病预防控制中心预科院，贵州 贵阳 550004)])], figs=[ArticleFig(id=1241139377242435801, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=EN, label=Table 1, caption=

Adverse reaction of RZV vaccination in different age groups ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应50～59岁60～69岁≥70岁合计χ2值P值
全身不良反应
发热80(30.65)50(25.77)9(13.24)139(26.58)8.7780.012
肌肉痛93(35.63)42 (21.65)8(11.76)143(27.34)6.6100.037
头痛47(18.01)28(14.43)3 (4.41)78(14.91)—0.012*
疲乏41(15.71)22 (11.34)3 (4.41)66(12.62)0.030*
皮疹7(2.68)3 (1.55)0(0.00)10(1.91)—0.445*
局部不良反应
局部疼痛92(35.25)53(27.32)14(20.59)159(30.40)6.8640.032
局部红肿20(7.66)5(2.58)1(1.47)26(4.97)—0.019*
总不良反应165(63.22)79(40.72)18(26.47)262(50.10)39.979<0.001
), ArticleFig(id=1241139377359876323, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=CN, label=表1, caption=

不同年龄段人群接种RZV发生不良反应的情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应50～59岁60～69岁≥70岁合计χ2值P值
全身不良反应
发热80(30.65)50(25.77)9(13.24)139(26.58)8.7780.012
肌肉痛93(35.63)42 (21.65)8(11.76)143(27.34)6.6100.037
头痛47(18.01)28(14.43)3 (4.41)78(14.91)—0.012*
疲乏41(15.71)22 (11.34)3 (4.41)66(12.62)0.030*
皮疹7(2.68)3 (1.55)0(0.00)10(1.91)—0.445*
局部不良反应
局部疼痛92(35.25)53(27.32)14(20.59)159(30.40)6.8640.032
局部红肿20(7.66)5(2.58)1(1.47)26(4.97)—0.019*
总不良反应165(63.22)79(40.72)18(26.47)262(50.10)39.979<0.001
), ArticleFig(id=1241139377460539627, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=EN, label=Table 2, caption=

Adverse reactions to RZV vaccination in different genders ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应女性男性合计χ2值P值
全身不良反应
发热81(22.44)58(35.80)139(26.58)10.2350.001
肌肉痛76(21.05)67(41.36)143(27.34)23.207<0.001
头痛45(12.47)33(20.37)78 (14.91)5.5060.019
疲乏37(10.25)29(17.90)66(12.62)5.3560.021
皮疹3(0.83)7(4.32)10(1.91)—0.120*
局部不良反应
局部疼痛120(33.24)39(24.07)159(30.40)4.4410.035
局部红肿17(4.71)9(5.56)26(4.97)0.7980.372
总不良反应162(44.88)100(61.73 )262(50.10)12.704<0.001
), ArticleFig(id=1241139377573785845, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=CN, label=表2, caption=

不同性别人群接种RZV发生不良反应的情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应女性男性合计χ2值P值
全身不良反应
发热81(22.44)58(35.80)139(26.58)10.2350.001
肌肉痛76(21.05)67(41.36)143(27.34)23.207<0.001
头痛45(12.47)33(20.37)78 (14.91)5.5060.019
疲乏37(10.25)29(17.90)66(12.62)5.3560.021
皮疹3(0.83)7(4.32)10(1.91)—0.120*
局部不良反应
局部疼痛120(33.24)39(24.07)159(30.40)4.4410.035
局部红肿17(4.71)9(5.56)26(4.97)0.7980.372
总不良反应162(44.88)100(61.73 )262(50.10)12.704<0.001
), ArticleFig(id=1241139377687032063, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=EN, label=Table 3, caption=

Adverse reactions to RZV vaccination in people with different body weight ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应消瘦正常超重/肥胖合计χ2值P值
全身不良反应
发热58(28.43)72(28.92)9 (12.86)139 (26.58)7.8100.020
肌肉痛55 (26.96)76(30.52))12 (17.14)143 (27.34)10.1110.006
头痛42 (20.59)28(11.24)8 (11.43)78 (14.91)8.4880.014
疲乏31 (15.20)35(14.06)0 (0.00)66 (12.62)—<0.001*
皮疹2(0.98)8(3.21)0(0.00)10(1.91)—0.157*
局部不良反应
局部疼痛70 (34.31)76(30.52)13 (18.57)159 (30.40)6.1070.047
局部红肿5(2.45)19(7.63)2(2.86)26(4.97)—0.033*
总不良反应125(61.27)116(46.59)21( 30.00)262( 50.10)10.7760.005
), ArticleFig(id=1241139377791889672, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=CN, label=表3, caption=

不同体重人群接种RZV发生不良反应的情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应消瘦正常超重/肥胖合计χ2值P值
全身不良反应
发热58(28.43)72(28.92)9 (12.86)139 (26.58)7.8100.020
肌肉痛55 (26.96)76(30.52))12 (17.14)143 (27.34)10.1110.006
头痛42 (20.59)28(11.24)8 (11.43)78 (14.91)8.4880.014
疲乏31 (15.20)35(14.06)0 (0.00)66 (12.62)—<0.001*
皮疹2(0.98)8(3.21)0(0.00)10(1.91)—0.157*
局部不良反应
局部疼痛70 (34.31)76(30.52)13 (18.57)159 (30.40)6.1070.047
局部红肿5(2.45)19(7.63)2(2.86)26(4.97)—0.033*
总不良反应125(61.27)116(46.59)21( 30.00)262( 50.10)10.7760.005
), ArticleFig(id=1241139377930301716, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=EN, label=Table 4, caption=

Adverse reactions of RZV vaccination in people with different underlying diseases ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应内分泌病史心血管病史带状疱疹病史无基础疾病合计χ2值P值
全身不良反应
发热28(38.89)32(28.32)11(16.92)74(25.34)145(26.75)9.0540.029
肌肉痛35(48.61)23(20.35)15(23.08)70(23.97)143(26.38)21.670<0.001
头痛25(34.72)24(21.24)5(7.69)28(9.59)82(15.13)34.591<0.001
疲乏16(22.22)21(18.58)6(9.23)24(8.22)67(12.36)15.7140.001
皮疹5 (6.94)2(1.77)1(1.54)2(0.68)10(1.85)—0.012*
局部不良反应
局部疼痛31(43.06)45(39.82)24(36.92)82(28.08)182(33.58)9.1560.027
局部红肿7(9.72)9(7.96)2(3.08)8(2.74)26(4.80)—0.021*
总不良反应51(70.83)72(63.72)35(53.85)130(44.52)288(53.14)22.858<0.001
), ArticleFig(id=1241139378060325150, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036338754016207, language=CN, label=表4, caption=

不同基础疾病人群接种RZV发生不良反应的情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
不良反应内分泌病史心血管病史带状疱疹病史无基础疾病合计χ2值P值
全身不良反应
发热28(38.89)32(28.32)11(16.92)74(25.34)145(26.75)9.0540.029
肌肉痛35(48.61)23(20.35)15(23.08)70(23.97)143(26.38)21.670<0.001
头痛25(34.72)24(21.24)5(7.69)28(9.59)82(15.13)34.591<0.001
疲乏16(22.22)21(18.58)6(9.23)24(8.22)67(12.36)15.7140.001
皮疹5 (6.94)2(1.77)1(1.54)2(0.68)10(1.85)—0.012*
局部不良反应
局部疼痛31(43.06)45(39.82)24(36.92)82(28.08)182(33.58)9.1560.027
局部红肿7(9.72)9(7.96)2(3.08)8(2.74)26(4.80)—0.021*
总不良反应51(70.83)72(63.72)35(53.85)130(44.52)288(53.14)22.858<0.001
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523例≥50岁人群接种重组带状疱疹疫苗不良反应分析
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张飞雪 , 黄梅
现代预防医学 | 疾病预防控制 2025,52(17): 3235-3239
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现代预防医学 | 疾病预防控制 2025, 52(17): 3235-3239
523例≥50岁人群接种重组带状疱疹疫苗不良反应分析
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张飞雪, 黄梅
作者信息
  • 贵州省疾病预防控制中心预科院，贵州 贵阳 550004

    • 张飞雪（1973—），女，本科，主任医师，研究方向：妇幼卫生

通讯作者:

黄梅，E-mail:
Analysis of adverse reactions of 523 individuals aged ≥50 years who received recombinant herpes zoster vaccine
Fei-xue ZHANG, Mei HUANG
Affiliations
  • Guizhou Center for Disease Control and Prevention, Guizhou Academy of Public Heath and Preventive Medicine, Guiyang,Guizhou 550004, China
出版时间: 2025-09-10 doi: 10.20043/j.cnki.MPM.202503495
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摘要
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目的

了解重组带状疱疹疫苗(recombinant zoster vaccine, RZV )用于≥50岁人群的不良反应发生率,为RZV的接种提供参考。

方法

2021年9月—2023年9月对贵州省疾病预防控制中心门诊部接种RZV的523例接种者数据进行分析。

结果

接种RZV的523例接种者中总的不良反应发生率50.10%，其中50～59岁、60～69岁及≥70岁的人群不良反应发生率分别为63.22%、40.72%、26.47%；女性、男性人群不良反应发生率分别为44.88%、61.73%；消瘦、正常、超重/肥胖的人群不良反应发生率分别为61.27%、46.59%、30.00%；有内分泌病史、心血管病史、带状疱疹病史的人群不良反应发生率分别为70.83%、63.72%、53.85%。

结论

贵阳≥50岁人群接种RZV不良反应发生率较低、多为轻症；发生率与年龄、性别、体重以及是否有基础疾病等存在差异，要因人而异做好RZV接种后的监测和处置。

重组带状疱疹疫苗  /  预防接种  /  不良反应
Objective

To investigate the incidence of adverse reactions of recombinant zoster vaccine (RZV) in people≥50 years, and to provide reference for RZV vaccination.

Methods

The data of 523 patients who received RZV in the outpatient department of Guizhou Center for Disease Control and Prevention from September 2021 to September 2023 were analyzed.

Results

A total of 523 patients were inoculated with the RZV and the overall incidence of adverse reactions was 50.10%. The incidence of adverse reactions was 63.22% in the 50-59 age group, 40.72% in the 60-69 group, and 26.47% in those aged ≥70 years. Among females and males, the incidence was 44.88% and 61.73%, respectively. The incidence was 61.27% in underweight individuals, 46.59% in those with normal weight, and 30.00% in those who were overweight or obese. Patients with a history of endocrine disease, cardiovascular disease, and shingles showed incidences of 70.83%, 63.72%, and 53.85%, respectively.

Conclusion

The incidence of adverse reactions following RZV vaccination in individuals ≥50 years in Guiyang is relatively low, and most adverse reactions are mild. The incidence rate is influenced by factors such as age, gender, weight, and the presence of underlying diseases. Post-vaccination monitoring and treatment following RZV administration should be tailored to each individual.

Recombinant zoster vaccine  /  Vaccination  /  Adverse reaction
张飞雪, 黄梅. 523例≥50岁人群接种重组带状疱疹疫苗不良反应分析. 现代预防医学, 2025 , 52 (17) : 3235 -3239 . DOI: 10.20043/j.cnki.MPM.202503495
Fei-xue ZHANG, Mei HUANG. Analysis of adverse reactions of 523 individuals aged ≥50 years who received recombinant herpes zoster vaccine[J]. Modern Preventive Medicine, 2025 , 52 (17) : 3235 -3239 . DOI: 10.20043/j.cnki.MPM.202503495
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带状疱疹（herpes zoster）是由感染水痘-带状疱疹病毒（varicella-zoster virus, VZV）引起，以簇集性小水泡为表现，多伴随明显神经痛的一种皮肤病。VZV进入人体后，表现为水痘或隐性感染潜伏于神经节内，当机体免疫力下降（外伤、恶性肿瘤、虚弱、劳累、感冒等）潜伏的病毒激活，引发带状疱疹[1]。据估计，99%的40岁以上成年人有VZV感染的血清学证据，有发展为带状疱疹的风险[2]，尤其是女性、老年人和免疫功能低下的人群[3]。据统计，大于50%的带状疱疹患者均为年龄超过50岁的人群。在我国，每年大于50岁的人群新增感染带状疱疹约156万人[4]。同时，随着年龄的增加神经痛也逐渐加剧，严重的持续数周、数月甚至数年。感染带状疱疹后60岁或以上的成年人神经痛的发生率为66.5%[5]。另外，有证据表明带状疱疹感染后可能引发体内的炎症反应、自主神经系统功能障碍等导致心血管疾病并发症，特别是免疫系统的激活在感染带状疱疹期间可能引起血管炎症和心力衰竭[6]等，带状疱疹患者出现中风的几率增加1.9倍[7]。
带状疱疹患者只能给予阿昔洛韦、伐昔洛韦等抗病毒治疗[8]以减轻症状，却不能从根本阻断病毒的激活，没有特效的止疼药去解决神经痛。带状疱疹感染严重影响患者的健康和生活质量，甚至给患者造成严重的经济负担。随着重组带状疱疹疫苗(recombinant zoster vaccine, RZV )的问世，它不仅可以有效的预防带状疱疹，还可以减少因带状疱疹感染伴随而来的相关疾病及经济负担。因此，贵州省疾病预防控制中心从2021年开展了≥50岁人群RZV的接种，为制定带状疱疹疫苗的免疫策略及推广普及提供安全监测依据，现将接种后的不良反应情况分析如下。
1　对象与方法
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1.1　调查对象
2021年9月—2023年9月在贵州省疾病预防控制中心门诊接种RZV的接种者共计882例，排除未完成接种二剂RZV者、不愿接受问卷调查、有语言障碍和行动不方便者，共调査了523例。纳入标准：（1）已经全程接种二剂RZV；（2）自愿同意接受调查；（3）语言表述正常；（4）行动自如。
1.2　疫苗来源及接种
本疫苗是由葛兰素史克集团生产的RZV（每剂含水痘带状疱疹病毒糖蛋白E和ASO1B佐剂系统,规格为0.5 ml），商品名为欣安立适，适用于50岁及以上成人预防带状疱疹，仅限肌肉注射，首选上臂三角肌，免疫程序为两剂，每剂0.5 ml，第二剂与第一剂间隔2～6个月。
1.3　调查方法和内容
通过对接种对象面诊的方式进行调查，调查的内容包括年龄、性别、身高、体重、既往病史［带状疱疹病史、心血管病史（高血压、高血脂、冠心病）］、内分泌病史（糖尿病、甲状腺功能亢进、甲状腺功能减退）、接种RZV的不良反应表现（根据RZV说明书中提到不良反应常见表现，全身不良反应如：发热、肌肉痛、头痛、疲乏等，局部不良反应如：局部疼痛/红肿/硬结等）以及严重程度（根据预防用疫苗临床试验不良事件分级标准指导原则中提到不良反应程度分级，如：1级指轻度，不影响活动、无需治疗；2级指中度，轻度影响活动、不需或仅需轻度治疗；3级指重度，明显影响活动、需治疗或住院；4级指危重度，严重影响活动甚至有生命危险、需住院及监护[9])。根据身高和体重计算出身体质量指数（body mass index, BMI），计算公式为BMI=体重（kg）/身高的二次方（m2）。并根据BMI进行分级，BMI<18.5 kg/m2视为消瘦，18.5 kg/m2≤BMI<24.0 kg/m2视为正常，24.0 kg/m2≤BMI<28.0 kg/m2视为超重，BMI≥28.0 kg/m2视为肥胖，男女标准相同[10]。
1.4　统计分析
应用SPSS 22.0统计软件对数据进行统计学分析及χ2检验进行比较，检验水准α=0.05。不良反应发生率（%）=已接种带状疱疹疫苗发生不良反应的例数/已接种带状疱疹疫苗的例数×100%。
2　结果
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2.1　调查对象基本情况
调查对象523人，其中女性361人、占69.02%，男性162人、占30.98%；50～59岁261人、占49.91%，60～69岁194人、占37.09%，≥70岁68人、占13.00%；消瘦204人、占39.00%，正常249人、占47.61%，超重/肥胖70人、占13.39%；无基础疾病292例、占53.88%，有内分泌病史72例、占13.28%，心血管病史113例、占20.85%，带状疱疹病史的65例、占11.99%。
2.2　不良反应发生情况
523人接种RZV后总共有262例发生不良反应，发生率为50.10%。其中1级、2级不良反应发生率分别为45.51%（238/523）、4.59%（24/523）,无3级、4级不良反应发生。
2.2.1　不同年龄段人群接种RZV不良反应发生的情况
50～59岁的人群接种RZV发生不良反应的发生率为63.22%（165/261），60～69岁的人群接种RZV发生不良反应的发生率为40.72%（79/194），≥70岁的人群接种RZV发生不良反应的发生率为26.47%（18/68）。其中，50～59岁人群不良反应发生率以肌肉痛最高，占35.63%（93/261），60～69岁以及≥70岁的则是以局部疼痛为主，分别占27.32%（53/194）、20.59%（14/68）。不同年龄段人群不良反应发生率差异有统计学意义（χ2=39.979，P<0.001）。见表1。
2.2.2　不同性别人群接种RZV不良反应发生的情况
女性和男性人群接种RZV发生不良反应的发生率分别为44.88%（162/361）、61.73%（100/162）。其中，女性和男性人群不良反应发生率中分别以局部疼痛和肌肉痛为主，分别为33.24%（120/361）、41.36%（67/162）。不同性别人群不良反应发生率差异有统计学意义（χ2=12.704，P<0.001），见表2。
2.2.3　不同体重人群接种RZV不良反应发生的情况
消瘦人群接种RZV发生不良反应的发生率为61.27%(125/204)，正常人群接种RZV发生不良反应的发生率为46.59%(116/249)，超重/肥胖人群接种RZV发生不良反应的发生率为30.00%(21/70)。不同体重人群不良反应发生率差异有统计学意义（χ2=10.776，P<0.05），见表3。
2.2.4　不同基础疾病人群接种RZV不良反应发生的情况
有内分泌病史的人群接种RZV发生不良反应的发生率为70.83%(51/72)，有心血管病史的人群接种RZV发生不良反应的发生率为63.72%(72/113)，有带状疱疹病史的人群接种RZV发生不良反应的发生率为53.85%(35/65)，无基础疾病的人群接种RZV发生不良反应的发生率为44.52%(130/292)。其中，有内分泌病史的人群中不良反应发生率肌肉痛最高，为48.61%（35/72），而有心血管病史、带状疱疹病史以及无基础疾病的人群均以局部疼痛为主。不同基础疾病人群不良反应发生率差异有统计学意义，（χ2=22.858，P<0.001），见表4。
3　讨论
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RZV自2019年5月在我国批准上市用于≥50人群至今，全国各地在逐渐使用RZV来预防带状疱疹感染，但是总体的接种率不是很理想，接种意愿也不高[11]，如：北京朝阳区[12]、上海崇明区[13]及山东[14]等地。究其原因主要是对接种RZV的安全性及必要性存在顾虑和质疑。
本研究显示，RZV接种后不良反应发生率为50.10%,低于李娟[15]以及欧美一些国家报道的数据[16-19]，主要表现为局部疼痛、肌肉痛、发热、头痛、疲乏，均为轻、中度，无严重及罕见的不良反应发生，1～3 d后自行缓解，无一例需要治疗。
本研究显示，50～59岁的人群接种RZV后不良反应的发生率(63.22%)分别比60～69岁人群(40.72%)和≥70岁人群发生率(26.47%)高22.50%、36.75%。这是因为随着年龄的增长、衰老不可避免，免疫系统会发生变化，免疫功能慢慢减退、免疫反应越来越弱，也就是通常所说的“免疫衰老”[20]。50～59岁的人群不良反应的表现以肌肉痛为主，而60～69岁、≥70岁的人群均以局部疼痛为主。对于肌肉痛，认为是疫苗的ASO1B佐剂系统具有较强的诱导炎症反应的能力，从而引发肌肉痛等不良反应[21]；即便如此，添加ASO1B佐剂体系的疫苗也具有较好的安全性[22]。肌肉痛，通常会自行好转，必要时可按摩缓解。对于局部疼痛/红肿的，考虑与疫苗成分对局部的刺激、注射器注射时的角度和深度等有关[23]。一般可观察，注意局部清洁，避免感染，必要时24 h内予以局部冷敷，超过24 h后可热敷缓解。
本研究发现，接种RZV后发生不良反应的发生率存在一定的性别差异，男性接种RZV发生不良反应的发生率高于女性，与Tavares[24]、Hesse[25]等报道的女性高于男性不吻合。不良反应存在性别差异的具体原因尚未明确，有可能是荷尔蒙影响了免疫反应的原因[26]。
本研究显示，消瘦的人群接种RZV后不良反应的发生率为61.27%，明显高于正常人群的46.59%和超重/肥胖人群的30.00%；超重/肥胖的人群接种RZV后不良反应的发生率最低，为30.00%。因此要重视消瘦人群接种RZV后的不良反应。
本研究显示，有内分泌病史、有心血管病史、有带状疱疹病史的人群的不良反应发生率高于无基础疾病的人群。要关注有内分泌病史、心血管病史、带状疱疹病史的人群接种RZV后的反应，特别是对于有发热和低热情况的，考虑与抗原含量、抗原亲神经性的特征等因素有关[27]。嘱其要注意多饮水外，若体温超过38.5℃必要时给予物理降温等对症处理。
综上，贵阳≥50岁居民接种RZV后不良反应率为50.10%，接种后没有严重的不良反应，体现安全性高。因此，我们应加强宣传感染带状疱疹带来的影响及危害性和接种RZV带来的益处及必要性，提高居民对RZV安全性的认识，解除对接种的疑虑和犹豫。同时，因RZV不良反应的发生与年龄、性别、体重以及是否有基础疾病等存在差异，故要因人而异做好疫苗接种后的监测，尤其重视50～59岁、男性、消瘦的人群，以及有内分泌病史、心血管病史和带状疱疹病史的人群；并且在接种前，详细了解接种人员的健康、是否存在禁忌及暂缓接种等有关情况，做好接种前的告知安抚以及接种后不良反应不同表现的处理，让接种者做到心中有数，避免情绪紧张、过分担忧；同时，嘱其接种RZV后注意休息、注意睡眠、避免剧烈运动、清淡饮食、适当多饮水，以减轻不良反应带来的身体不适。
基金
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  • 贵州省卫生健康委科学技术基金项目(gzwkj2023-072)
文献
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2025年第52卷第17期
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doi: 10.20043/j.cnki.MPM.202503495
  • 接收时间：2025-03-25
  • 首发时间：2026-03-18
  • 出版时间：2025-09-10
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  • 收稿日期：2025-03-25
基金
贵州省卫生健康委科学技术基金项目(gzwkj2023-072)
作者信息
    贵州省疾病预防控制中心预科院，贵州 贵阳 550004

通讯作者:

黄梅，E-mail:
参考文献
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https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202503495
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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