15岁及以下儿童接种国产脑膜炎球菌疫苗免疫原性的Meta分析  

Meta-analysis on the immunogenicity of domestic meningococcal vaccine among children of 15 years old and under

作　　者：滕冲[1] 尹遵栋[1] 李艺星[1] 宁桂军[1] 李军宏[1] 吴丹[1] 李黎[2] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050 [2]中华预防医学会

出　　处：《中国预防医学杂志》2017年第7期527-533,共7页Chinese Preventive Medicine

摘　　要：目的系统评价儿童接种含A群、C群组分的国产脑膜炎球菌疫苗的免疫原性。方法检索美国国家医学图书馆数据库、中国期刊全文数据库、万方全文数据库等,筛选出有关含A群、C群组分的国产脑膜炎球菌疫苗免疫原性的研究。以血清杀菌力试验(serum bactericidal activity,SBA)检测儿童接种1剂次或2剂次脑膜炎球菌疫苗的血清抗体阳转率(seroconversion rate,SR)作为结局指标,采用R 3.2.0软件合并所有单个研究的SR和对照研究的抗体阳转率率差(risk difference,RD),按异质性判定标准选择M-H法(maenszel-haenszel)分析的固定效应模型结果和D-L法(dersimonian-laird)分析的随机效应模型结果。结果纳入23篇文献,7篇为脑膜炎球菌多糖疫苗(meningococcal polysaccharide vaccine,MPSV)和脑膜炎球菌多糖结合疫苗(meningococcal polysaccharide-protein conjugate vaccine,MPCV)比较的对照研究,其余均为非对照研究。2岁儿童接种2剂次MPSV后A群和C群的SR分别为78.54%和62.82%。2~15岁儿童接种1剂MPSV后A群和C群的SR分别为94.25%和94.71%;2岁儿童接种2剂次MPCV后A群和C群的SR分别为98.78%和98.44%;2~15岁儿童接种1剂次MPCV后A群和C群的SR分别为98.54%和97.79%。在MPSV和MPCV比较研究中,2岁的儿童接种2剂次后A群的抗体阳转率RD为0.19(95%CI:0.03~0.35);2~15岁接种1剂次后A群和C群抗体阳转率RD分别为0.05(95%CI:-0.01~0.11)和0.06(95%CI:-0.06~0.17)。结论 2岁儿童接种含A群、C群组分MPCV的免疫原性优于同组分的MPSV,含A群、C群组分的MPSV和MPCV均可在2~15岁儿童中产生良好的免疫原性。Objective To systematically assess the immunogenicity of domestic meningococcal vaccine （Men V） containing serogroup A or C components in children of 15 years old and under. Methods Databases as PubMed, China Biology Medicine disc （CBMd）, China National Knowledge Infrastructure （CNKI） and Wanfang were searched for the studies about immunogenicity of domestic Men V containing serogroup A and C components. The seroconversion rate after one or two doses vaccination determined by serum bactericidal activ ity assays （SBA） was used as outcome indicator. The seroconversion rate of all studies and risk difference （RD） of control studies were analyzed by R 3.2.0 software. Based on the heterogeneity standard, the results of the fixed effect model of maenszer-haenszel and the random effect of dersimonian laird were analyzed. Re- suits Twenty-three studies were included in the analysis, of which 7 studies compared meningococcal polysac- charide vaccine （MPSV） with meningococcal polysaccharide conjugate vaccine （MPCV）. The seroconversion rates targeting serogroup A and C among children under 2 years were 78.54% and 62.82% after two doses of MPSV, and 98.78% and 98.44% after two doses of MPCV, they were 94.25% and 94.71% among children aged 2 to 15 years with one dose MPSV, and 98.54% and 97.79% with one dose of MPCV. In studies comparing MPSV with MPCV, the RD of seroconversion rate of antibodies against serogroup A among chil- dren of under 2 years with one dose of MPCV was 0. 19 （95%CI： 0.03-0.35） .While, in children aged 2-15 years with one dose of MPCV, the RDs of seroconversion rates against serogroup A and C were 0.05 （95% CI： -0.01 0.11） and 0.06 （95%CI： -0.06 0.17）, respectively. Conclusions The immunogenicity of MPCV is higher than that of MPSV in children under 2 years old, while the immunogenicity in children aged 2 15 years is basically the same.

关 键 词：流行性脑脊髓膜炎 脑膜炎球菌疫苗 免疫原性 血清抗体阳转 META分析 

分 类 号：R186[医药卫生—流行病学]