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PCV13对苏州地区儿童社区获得性肺炎保护效果评价

李赵进 陈庆会 栾琳 陶云珍 冯爽 张优仪 田健美 邵雪君 赵根明 张钧 张涛

李赵进, 陈庆会, 栾琳, 陶云珍, 冯爽, 张优仪, 田健美, 邵雪君, 赵根明, 张钧, 张涛. PCV13对苏州地区儿童社区获得性肺炎保护效果评价[J]. 中国公共卫生, 2022, 38(11): 1435-1439. doi: 10.11847/zgggws1137785
引用本文: 李赵进, 陈庆会, 栾琳, 陶云珍, 冯爽, 张优仪, 田健美, 邵雪君, 赵根明, 张钧, 张涛. PCV13对苏州地区儿童社区获得性肺炎保护效果评价[J]. 中国公共卫生, 2022, 38(11): 1435-1439. doi: 10.11847/zgggws1137785
LI Zhao-jin, CHEN Qing-hui, LUAN Lin, . Effectiveness of 13-valent pneumococcal polysaccharide conjugate vaccine on community-acquired pneumonia: a retrospective cohort study among young children in Suzhou city[J]. Chinese Journal of Public Health, 2022, 38(11): 1435-1439. doi: 10.11847/zgggws1137785
Citation: LI Zhao-jin, CHEN Qing-hui, LUAN Lin, . Effectiveness of 13-valent pneumococcal polysaccharide conjugate vaccine on community-acquired pneumonia: a retrospective cohort study among young children in Suzhou city[J]. Chinese Journal of Public Health, 2022, 38(11): 1435-1439. doi: 10.11847/zgggws1137785

PCV13对苏州地区儿童社区获得性肺炎保护效果评价

doi: 10.11847/zgggws1137785
详细信息
    作者简介:

    李赵进(1995 – ),男,江西上饶人,硕士在读,研究方向:疾病预防控制

    通讯作者:

    张涛,E-mail:tzhang@shmu.edu.cn

  • 中图分类号: R 186

Effectiveness of 13-valent pneumococcal polysaccharide conjugate vaccine on community-acquired pneumonia: a retrospective cohort study among young children in Suzhou city

  • 摘要:   目的  评价13价肺炎球菌结合疫苗(13-valent pneumococcal conjugate vaccine, PCV13)对苏州地区儿童社区获得性肺炎(community-acquired pneumonia,CAP)的保护效果。  方法   采用队列研究,以2017年12月1日 — 2019年6月30日到苏州大学附属儿童医院(SCH)就诊或住院治疗的苏州地区0~18月龄儿童为研究对象,通过苏州市疾病预防控制中心的免疫信息系统查询儿童疫苗接种信息建立队列,从SCH信息系统收集研究对象的门诊和住院信息进行随访,采用Cox比例风险模型估计接种不同剂次PCV13的保护率。  结果   2017年12月1日 — 2019年6月30日,共59927名苏州地区儿童纳入研究,其中接种组共7459人(12.4 %)。对于第一次门诊或住院诊断CAP,至少接种1、2和3剂次PCV13的保护率分别为10.1 %(95 % CI = 3.3 %~18.1 %)、15.7 %(95 % CI = 7.6 %~23.1 %)和20.3 %(95 % CI = 11.5 %~28.3 %),对于所有门诊或住院诊断全CAP,至少接种1、2和3剂次PCV13的保护率分别为13.1 %(95 % CI = 6.0 %~20.0 %)、17.5 %(95 % CI = 10.0 %~24.5 %)和22.2 %(95 % CI = 14.0 %~30.0 %)。  结论   PCV13对苏州地区儿童社区获得性肺炎具有保护效果,接种满3剂次效果最好。
  • 表  1  PCV13各剂次队列基本情况描述

    特征总调查
    人数
    %对照组至少接种1剂次PCV13至少接种2剂次PCV13至少接种3剂次PCV13
    人数%人数%χ2人数%χ2人数%χ2
    性别2.914.36 a4.05 a
     女性2735545.62388145.5347446.6335146.8312146.8
     男性3257254.42858754.5398553.4380453.2354453.2
    苏州市区1201.00 b1184.13 b1165.40 b
     姑苏区55789.344158.4116315.6110215.4102115.3
     虎丘区52638.845628.77019.46629.35999
    工业园区749812.5691213.25867.95597.85127.7
     昆山区773612.9724513.84916.64586.44146.3
     吴江区1093518.2917217.5176323.6172624.1163024.5
     吴中区1040717.4873616.7167122.4161222.5153423
     相城区739012.3675012.96408.66078.55528.3
    其他县/区51208.546768.944464296.04036
    接种Hib疫苗6646.23 b6671.96 b6475.15 b
    至少接种1剂次1099518.3707613.5391952.5381153.3358053.7
    未接种4893281.74539286.5354047.5334446.7308546.3
    接种流感疫苗131.95 b137.63 b142.61 b
     至少接种1剂次2400.41510.3891.2881.2851.3
     未接种5968799.65231799.7737098.8706798.8658098.7
    基础疾病c1.522.102.91
     至少伴有1种疾病35185.931045.94145.63925.53595.4
     不伴有疾病5640994.14936494.1704594.4 676394.5 630694.6 
      注:各剂次队列都与对照组比较,a P < 0.05,b P < 0.001;c 包括先天性心脏病、早产、血液、免疫、神经、肾脏、慢性肺部疾病和低出生体重。
    下载: 导出CSV

    表  2  接种PCV13对首诊CAP发病的保护效果

    不同剂次队列观察人数观察人年数发病例数ID(1/10万人年)RRVE % b95 % CIPc
    RR95 % CIaRRa95 % CI
    1剂次
     接种组74595524.5069012489.820.830.80~0.850.890.82~0.9710.13.3~18.10.006
     对照组5246842365.32639015083.091.001.00
    2剂次
     接种组71554572.1455212073.120.790.76~0.820.840.77~0.9215.77.6~23.1 < 0.001
     对照组5246837435.37571715271.651.001.00
    3剂次
     接种组66653583.0941011442.630.750.72~0.790.800.72~0.8920.311.5~28.3 < 0.001
     对照组5246832294.05492015235.001.001.00   
      注:a Cox回归调整后的RR,b 1 − aRR得到,c Wald检验的P 值。
    下载: 导出CSV

    表  3  接种PCV13疫苗对儿童全CAP发病的保护效果

    不同剂次队列观察人数观察人年数发病例数ID(1/10万人年)RRVE % b95 % CIPc
    RR95 % CIaRRa95 % CI
    1剂次
     接种组75085536.1373913348.680.810.79~0.840.870.80~0.9413.16.0~20.0 < 0.001
     对照组5306542530.14698716428.351.001.00
    2剂次
     接种组71914580.3858812837.360.780.75~0.800.830.76~0.9017.510.0~24.5 < 0.001
     对照组5296537569.6621416539.971.001.00
    3剂次
     接种组66903588.6743512121.50.740.70~0.770.780.70~0.8622.214.0~30.0 < 0.001
     对照组5287932398.12533116454.661.001.00   
      注:a Cox回归调整后的RR,b 1 − aRR得到,c Wald检验的P 值。
    下载: 导出CSV

    表  4  接种PCV13疫苗对儿童再发CAP发病的保护效果

    不同剂次队列观察人数观察人年数发病人数ID(1/10万人年)RRVE % b95 % CIPc
    RR95 % CIaRRa95 % CI
    1剂次
     接种组 6818 5232.35 49 936.48 0.62 0.53~0.72 0.63 0.80~0.94 37.5 15.3~54.0 0.002
     对照组 46675 39509.33 597 1511.04 1.00 1.00
    2剂次
     接种组 6639 4361.54 36 825.4 0.58 0.49~0.70 0.59 0.76~0.90 40.7 15.7~58.3 0.004
     对照组 47248 35165.1 497 1413.33 1.00 1.00
    3剂次
     接种组 6280 3441.51 25 726.43 0.54 0.43~0.68 0.54 0.70~0.86 46.1 18.1~64.5 0.004
     对照组 47959 30563.7 411 1344.73   1.00   1.00      
      注:a Cox回归调整后的RR,b 1 − aRR得到,c Wald检验的P 值。
    下载: 导出CSV
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  • 收稿日期:  2021-12-21
  • 网络出版日期:  2022-09-20
  • 刊出日期:  2022-11-30

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