新冠病毒疫苗接种对肺功能的保护作用及早期新冠肺炎的影响  

The protective effect of COVID-19 vaccination on incidence of COVID-19 pneumonia and pulmonary function in early convalescence phase

作　　者：许诺[1] 沈志文 杨燕平 陈智鸿[1] 李丽[1] XU Nuo;SHEN Zhi-wen;YANG Yan-ping;CHEN Zhi-hong;LI Li(Department of Pulmonary and Critical Care Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Infectious Disease and Biosecurity,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院呼吸与危重医学科,上海200032 [2]上海市重大传染病和生物安全研究院,上海200032

出　　处：《复旦学报（医学版）》2024年第4期574-579,593,共7页Fudan University Journal of Medical Sciences

摘　　要：目的探讨新冠病毒疫苗接种对新冠病毒感染患者肺功能的影响以及新冠病毒疫苗接种对感染患者的保护作用。方法选取2023年1月7日至2023年2月7日期间在复旦大学附属中山医院完成肺功能检查的1178例门诊及住院新冠感染患者,按照是否患有新冠肺炎分为两组,完成“新冠感染症状及肺功能相关调查表”,同时采集患者疫苗接种情况、临床症状、肺通气功能、弥散功能和呼出气一氧化氮结果(fractional exhaled nitric oxide,FeNO)等临床资料,通过χ^(2)检验、Pearson相关性分析、单因素及多因素Logistic回归模型等方法分析接种和未接种新冠病毒疫苗患者肺功能的差异,并验证新冠病毒疫苗对新冠肺炎、新冠感染相关症状的保护作用。结果未接种新冠病毒疫苗的新冠感染患者通气及弥散肺功能较接种患者下降明显(P<0.05)。未接种过新冠病毒疫苗、有既往慢性病史的患者更容易发生新冠肺炎,二针/三针疫苗接种可以减少新冠肺炎的发生率(P<0.05),而接种一针无明显保护作用;既往慢性病病史患者,如发生新冠感染,容易出现严重症状,而接种新冠病毒疫苗可以减轻包括慢性病患者在内的新冠相关严重症状。结论新冠病毒感染可以造成患者肺通气及弥散功能下降,二针/三针新冠病毒疫苗的接种可能减轻新冠病毒感染对肺功能的损伤,减少新冠肺炎及严重症状的发生,完整的新冠病毒疫苗接种可能具有保护作用。Objective To investigate the impact of corona virus disease 2019(COVID-19)vaccination on incidence of COVID-19 pneumonia and pulmonary function in early convalescence phase.Methods A total of 1178 COVID‐19 patients from Zhongshan hospital,Fudan University were enrolled from 7 Jan 2023 to 7 Feb 2023 and divided into two groups according to the incidence of COVID-19 pneumonia.All the patients were asked to finish the questionnaire on COVID-19 related-symptoms,and other clinical parameters in our study.Vaccination situation,Pulmonary functions including ventilation,diffusion function and fractional exhaled nitricoxide(FeNO)were collected.T-tests and Chi-squared tests were used to analyze the protective effect of vaccination on pulmonary function and occurrence of COVID-19 pneumonia between groups.Univariate analysis and multivariate analysis were performed to predict the significant prognostic factors for incidence of COVID-19 pneumonia.Results Lung function including ventilation and diffusion function was significantly declined in unvaccinated patients than vaccinated patients(P<0.05).Those unvaccinated patients and patients with chronic diseases were more likely to have COVID-19 pneumonia and severe related symptoms.Vaccinated with two or three doses,rather than one dose of COVID-19 vaccines could protect the patients from COVID-19 pneumonia(P<0.05).Those with chronic diseases were inclined to have severe symptoms,while vaccination could alleviate the symptoms of those patients and patients with no history.Conclusion COVID-19 infection can impair the lung function of patients in early convalescence phase.COVID-19 vaccination could protect the patients from COVID-19 pneumonia,ameliorate the related symptoms and attenuate lung function decline.

关 键 词：新型冠状病毒肺炎(COVID-19) 疫苗接种 肺功能 

分 类 号：R563[医药卫生—呼吸系统]