两种疫苗联合接种对慢性阻塞性肺病患者防治效果的Meta分析  

Effect of simultaneous inoculation with two kinds of vaccines on chronic obstructive pulmonary disease:a Meta-analysis

作　　者：刘晓[1] 廖俊喆 杨蕴梅[1] 刘波[1] 汪俊[1] 

机构地区：[1]四川省成都市第五人民医院呼吸内科,611130

出　　处：《检验医学与临床》2015年第24期3620-3622,3625,共4页Laboratory Medicine and Clinic

基　　金：四川省卫生厅科学研究资助项目(100044)

摘　　要：目的系统比较流感疫苗和肺炎球菌疫苗的联合接种与常规对症治疗对慢性阻塞性肺病患者的防治效果。方法计算机检索流感疫苗和肺炎球菌疫苗的联合接种(联合接种组)对比常规对症治疗(对照组)慢性阻塞性肺病患者的随机对照研究。2位研究者对纳入研究的质量、提取数据进行独立评价,采用Revman 5.2.7软件进行统计分析。结果纳入6个研究,总计有322例慢性阻塞性肺病患者。其中应用流感疫苗和肺炎球菌疫苗联合接种组为172例,对照组150例。Meta分析结果显示,与对照组相比,联合疫苗组能够明显降低慢性阻塞性肺病患者的平均住院天数(MD=-7.06,95%CI:-9.16~4.96,P<0.05)、急性发作间距天数(MD=93.48,95%CI:65.55~121.41,P<0.05)、病死率(RR=0.22,95%CI:0.08-0.61,P=0.004)、急性发作次数(MD=-3.46,95%CI:-3.76^-3.16,P<0.05)、平均住院次数(MD=-2.23,95%CI:-2.54^-1.91,P<0.05)、急性发作天数(MD=-2.71,95%CI:-4.67^-0.74,P<0.05)。结论相比对照组,联合接种组可以明显降低慢性阻塞性肺病患者的平均住院天数、急性发作间距天数、病死率、急性发作次数、平均住院次数及急性发作天数,但是低质量的原始研究可能大大降低证据的可信度,对于此课题还需要更多更科学、更可靠的临床试验去证实和研究。Objective To evaluate the efficacy of simultaneous inoculation with pneumococcal polysaccharide vaccine and influenza vaccine in the prevention and cure of chronic obstructive pulmonary disease,comparing with conventional symptomatic treatment.Methods Systematic literature retrieval was carried out to obtain randomized controlled trials of pneumococcal polysaccharide vaccine combined with influenza vaccine and conventional symptomatic treatment against chronic obstructive pulmonary disease before June 2015.Methodological quality assessment and data collection were performed by two individual reviewers.Meta-analysis was performed by Revman 5.2.7software.Results Totally 6studies with 322 chronic obstructive pulmonary disease patients were included.In which,there were 172 cases treated by simultaneous inoculation with pneumococcal polysaccharide vaccine and influenza vaccine（simultaneous inoculation group）,and 150 cases treated by conventional symptomatic treatment（control group）.Meta-analysis showed that in simultaneous inoculation group,the average days of hospitalization（MD=-7.06,95%CI：-9.16--4.96,P〈0.05）,acute attack distance days（MD=93.48,95%CI：65.55- 121.41,P〈0.05）,mortality（RR = 0.22,95% CI：0.08- 0.61,P = 0.004）,frequency of acute attack（MD =- 3.46,95%CI：-3.76--3.16,P〈0.05）,average hospitalization time（MD=-2.23,95%CI：-2.54--1.91,P〈0.05）,and days of acute attack（MD=-2.71,95%CI：-4.67- 0.74,P〈0.05）were significantly reduced,comparing with control group.Conclusion Comparing with control group,the average days of hospitalization,acute attack distance days,mortality,frequency of acute attack,average hospitalization time,and days of acute attack of patients with chronic obstructive pulmonary disease were significantly reduced in simultaneous inoculation group.However,the low quality of the original studies might reduce the reliability of the evidence.More reliable and scientific clinical trials were needed to prove in this subject.

关 键 词：流感疫苗 肺炎球菌疫苗 慢性阻塞性肺病 系统评价 META分析 

分 类 号：R563.1[医药卫生—呼吸系统]