慢性阻塞性肺疾病初诊患者流感和肺炎疫苗接种状况及影响因素:真实世界横断面研究  

Status of vaccination and related influencing factors in patients with chronic obstructive pulmonary disease:a real-world cross-sectional study

作　　者：刘聪 彭雅婷[1] 李静[1] 林铃 宋庆 成玮 曾玉琴[1] 陈平[1] Liu Cong;Peng Yating;Li Jing;Lin Ling;Song Qing;Cheng Wei;Zeng Yuqin;Chen Ping(Department of Pulmonary and Critical Care Medicine,the Second Xiangya Hospital,Central South University Research Unit of Respiratory Disease,Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院呼吸与危重症医学科中南大学呼吸疾病研究所,长沙410011

出　　处：《中华结核和呼吸杂志》2022年第4期355-361,共7页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家自然科学基金(81770046)。

摘　　要：目的调查慢性阻塞性肺疾病(简称慢阻肺)初诊患者流感、肺炎疫苗接种现状,分析影响疫苗接种的因素。方法连续纳入2016年12月至2019年12月在中南大学湘雅二医院呼吸科门诊初次就诊的慢阻肺患者3177例,其中男2683例,女494例,年龄20~89(62.1±9.0)岁,询问患者就诊后1年内疫苗接种状况,分析患者的一般情况和调查资料,用logistic回归分析与疫苗未接种的相关因素。结果慢阻肺患者总体流感疫苗、肺炎疫苗及流感联合肺炎疫苗接种率分别为2.3%(72/3177)、1.1%(34/3177)和1.1%(34/3177)。城镇患者流感疫苗接种率3.3%(41/1252),高于农村患者接种率1.6%(31/1925,P=0.002)。已戒烟患者流感疫苗、肺炎疫苗、流感联合肺炎疫苗接种率分别为3.3%(33/993)、2.1%(21/993)和2.1%(21/993),均高于目前仍吸烟的患者[1.7%(25/1467)、0.7%(11/1467)、0.7%(11/1467),P=0.034、0.015、0.015]。CAT<10分的慢阻肺患者流感疫苗接种率4%(27/673),高于CAT≥10分患者的接种率1.8%(45/2504,P=0.002)。农村居住(aOR值为1.73,95%CI:1.02~2.93,P=0.044)、吸烟(aOR值为2.10,95%CI:1.18~3.76,P=0.012)、CAT评分高(aOR值为2.06,95%CI:1.24~3.43,P=0.005),慢阻肺患者未接种疫苗的可能性更大。慢阻肺患者未接种疫苗最主要的原因是不知晓应接种疫苗(81.2%)。结论慢阻肺患者接种流感疫苗、肺炎疫苗及流感联合肺炎疫苗的比例均很低,且缺乏对疫苗的知晓。居住地、吸烟状态、症状与慢阻肺患者未接种疫苗相关,在对患者进行疫苗的健康宣教中需考虑到这些因素的影响。Objective To investigate the influenza and pneumonia vaccination rates in patients with chronic obstructive pulmonary disease(COPD),and analyze the factors affecting vaccination.Methods Totally 4016 COPD patients at the initial visit were included in the Respiratory Department of Xiangya Second Hospital of Central South University from December,2016 to December,2019.Each patient′s vaccination status after the visit for 1 year was reviewed,and finally 3177 patients were included in the analysis.Relevant factors affecting vaccination were analyzed with logistic regression.Results The overall vaccination rates of COPD patients with influenza vaccine,pneumonia vaccine and influenza combined pneumonia vaccine were 2.3%(72/3177),1.1%(34/3177)and 1.1%(34/3177),respectively.The influenza vaccination rate of urban patients(3.3%,41/1252)was higher than that of rural patients(1.6%,31/1925,P=0.002).The rates of influenza vaccine,pneumonia vaccine and influenza combined pneumonia vaccine in ex-smokers with COPD were 3.3%(33/993),2.1%(21/993),2.1%(21/993),respectively and 1.7%(25/1467),0.7%(11/1467),0.7%(11/1467),in current smokers with COPD,respectively(P=0.034,P=0.015,P=0.015,respectively).The influenza vaccination rate was higher in patients with COPD assessment test(CAT)scored less than 10(4%,27/673)than patients with CAT scored more than 10(1.8%,45/2504,P=0.002).In a multifactor analysis,patients who lived in country side,were current smokers,and had more symptoms were less likely to be vaccinated,with an aOR 1.73(95%CI 1.02-2.93),2.10(95%CI 1.18-3.76),2.06(95%CI 1.24-3.43),respectively.81.2%of COPD patients did not receive the vaccine because they did not know the vaccine.Conclusions Vaccination rates for influenza vaccine,pneumonia vaccine and both of them in COPD patients were low and the patients lacked knowledge of vaccine.The residence,smoking status and symptoms were related to the vaccination of COPD patients,and these should be taken into account in the vaccination health education.

关 键 词：肺疾病 慢性阻塞性 接种率 健康宣教 

分 类 号：R186[医药卫生—流行病学]