糖尿病患者接种SARS-Cov-2疫苗后的免疫反应:系统评价  

Immune response of diabetes patients after receiving SARS-Cov-2 vaccine:A systematic review

作　　者：王婧[1] 刘艳[1] 陈雅菲 苗茂华 WANG Jing;LIU Yan;CHEN Yafei;MIAO Maohua(Department of Immunization and Prevention,Hangzhou Center for Disease Control and Prevention,Hangzhou 310021,Zhejiang,China;Department of Public Health and Policy Research,Shanghai Institute of Biomedical and Pharmaceutical Technologies,Shanghai 200237,China)

机构地区：[1]杭州市疾病预防控制中心免疫预防所,浙江杭州310021 [2]上海生物医药技术研究院公共健康与政策研究所,上海2002371

出　　处：《中国现代医生》2024年第6期6-11,共6页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2024KY233)。

摘　　要：目的系统评价糖尿病患者在接种SARS-CoV-2疫苗后的体液和细胞免疫反应。方法检索Web of Science、PubMed、中国知网、万方数据知识服务平台、维普中文科技期刊全文数据库和中国生物医学文献数据库,获取国内外于2019年12月1日至2022年5月12日公开发表的有关糖尿病患者接种SARS-CoV-2疫苗后的体液和细胞免疫反应的观察性研究,经由2名研究者独立筛选文献和提取资料后,采用美国国立卫生研究质量评价工具对纳入文献进行偏倚风险评价,使用描述性统计方法进行汇总分析。结果13篇文献共纳入66651例研究对象,其中5874例(7.9%)患有糖尿病。7篇文献报道了接种第1剂疫苗后糖尿病患者和对照组的免疫反应,其中3篇文献表明,接种1剂SARS-CoV-2疫苗后,糖尿病患者血清抗体水平和阳性率低于对照组;11篇涉及接种2剂SARS-CoV-2疫苗后的免疫反应的文献中,2篇报道了糖尿病患者可产生与对照组相似的抗体反应,9篇报道了糖尿病患者的血清抗体水平、阳性率或细胞免疫反应低于对照组。结论接种SARS-CoV-2疫苗后糖尿病患者和对照组体液和细胞免疫反应均有所增加,但糖尿病患者增加幅度普遍低于对照组。Objective To evaluate the efficacy of SARS-CoV-2 vaccines in diabetic patients through a systematic review.Methods PubMed,Web of Science,CNKI,WanFang Data,CQVIP,and SinoMed databases were searched to identify observational studies which reported the humoral or cellular responses of SARS-CoV-2 vaccines in diabetic patients between December 1,2019 to May 12,2022.Two reviewers independently implemented literature screening and data extraction,and used the National Institute of Health Study Quality Assessment Tool to evaluate the methodological quality of the included studies.Results Thirteen studies with a total of 66651 subjects were identified,and 5874(7.9%)of them had diabetes.Immune responses against SARS-CoV-2 were increased after the vaccines in both diabetic patients and controls.Among the 7 studies that reported the immune response of diabetic patients after 1 dose of vaccine,3 literatures showed that the antibody levels and seropositivity rates of diabetic patients were lower than those of control group;Among the 11 studies that reported the immune responses after 2 doses of SARS-CoV-2 vaccines,2 studies reported that diabetic patients could produce antibody levels comparable to those in controls,and 9 studies showed that antibody levels,seropositivity rates or cellular immune response were lower than those of the control group.Conclusion The humoral and cellular immune responses increased in diabetic patients and control groups after the SARS-CoV-2 vaccines,but the increases in diabetic patients were generally lower than that in the control group.

关 键 词：SARS-CoV-2疫苗 体液免疫 细胞免疫 糖尿病 

分 类 号：R186[医药卫生—流行病学]