新冠疫苗接种对重症肌无力患者的安全性及其影响  

Safety of COVID-19 vaccination in patients with myasthenia gravis and its effect

作　　者：刘思思 李艳 薛红 赵芝兰 于明杰 赵琼 况时祥 LIU Sisi;LI Yan;XUE Hong;ZHAO Zhilan;YU Mingjie;ZHAO Qiong;KUANG Shixiang(The Second Clinical Medical School,Guizhou University of Traditional Chinese Medicine,Guiyang 550025,Guizhou,China;Department of Neurology,the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州中医药大学第二临床医学院,贵州贵阳550025 [2]贵州中医药大学第二附属医院神经内科,贵州贵阳550002

出　　处：《贵州医科大学学报》2025年第2期254-260,267,共8页Journal of Guizhou Medical University

基　　金：国家自然科学基金项目(82260884)。

摘　　要：目的探讨新冠疫苗接种对重症肌无力(myasthenia gravis,MG)患者的安全性及预防新冠肺炎和更严重事件的有效性。方法选取2022年12月—2023年1月在贵州中医药大学第二附属医院就诊的合并新型冠状病毒(coronavirus disease,COVID-19)感染的MG患者,评估MG患者既往疫苗接种后1个月内疫苗相关的不良反应,记录疫苗相关的MG症状加重的发生率和持续时间并分析其影响因素,在每个MG患者感染COVID-19后,进行为期1个月的监测并记录新冠肺炎及更严重事件的时间和发生率,根据MG患者是否接种过新冠疫苗将所有MG患者分为接种疫苗组和未接种疫苗组,比较两组的人口统计学和临床特征差异、合并COVID-19感染后MG患者新冠肺炎及更严重事件发生的风险。结果共纳入174例合并新型冠状病毒感染的MG患者,其中74例(42.5%)接种了新冠疫苗;接种疫苗组中有14.9%的人群在疫苗接种的1月内确认出现MG症状的加重,但与未接种组相比,差异无统计学意义(P=0.767);二元logistic回归分析显示45岁以上MG患者在疫苗接种后症状加重的风险较高(OR=7.83,P=0.005);在疫情期间,29/174名患者(16.7%)发展为新冠肺炎;未接种新冠疫苗组MG患者新冠肺炎及更严重事件发生率高于接种新冠疫苗组MG患者(P<0.05)。结论新冠疫苗接种对45岁以下MG人群整体是安全的、可耐受的,且能预防新冠肺炎及更严重事件的发生。Objective To investigate the safety of corona virus disease 2019(COVID-19)vaccination in patients with myasthenia gravis(MG)and its effectiveness in preventing COVID-19 and severe events.Methods MG patients with COVID-19 infection between December 2022 and January 2023 were selected at the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine.Vaccine-related adverse reactions in the patients with MG were assessed within one month after previous vaccination.The incidence and the duration of vaccine-related MG symptom exacerbation were documented,and its influencing factors were analyzed.After each patient with MG was infected with COVID-19,a 1-month monitoring was conducted,and the time and incidence of COVID-19 and more serious events were recorded.All MG patients were divided into vaccination and non-vaccination groups according to whether they had been vaccinated with COVID-19 vaccine.Two groups were compared for the differences in demography,clinical characteristics,novel coronavirus pneumonia of MG patients after COVID-19 infection as well as the risk of more serious events.Results A total of 174 MG patients had COVID-19 infection,among which,74 cases(42.5%)received COVID-19 vaccine.In vaccination group,14.9%of MG patients had the exacerbation of MG symptoms within one month of vaccination,but there was no statistically significant difference between vaccination and non-vaccination groups(P=0.767).Binary logistic regression analysis showed that MG patients aged over 45 years had a significantly increased risk of symptom exacerbation after vaccination(OR=7.83).During the epidemic,29/174 patients(16.7%)developed novel coronavirus pneumonia.The incidences of novel coronavirus pneumonia and more serious events were higher in non-vaccination group than those in vaccination group(P<0.05).Conclusion COVID-19 vaccination is generally safe and well-tolerated in MG patients younger than 45 years old,and it effectively reduces the risk of novel coronavirus pneumonia and severe events.

关 键 词：新型冠状病毒 重症肌无力 接种疫苗 安全性 严重程度 

分 类 号：R186[医药卫生—流行病学]