Wongsurakiat Phunsup, Maranetra Khun Nanta, Gulprasutdilog Penpun, Aksornint Monchai, Srilum Wichian, Ruengjam Chairat, Sated Wichean
Division of Respiratory Disease and Tuberculosis, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Respirology. 2004 Nov;9(4):550-6. doi: 10.1111/j.1440-1843.2004.00616.x.
The aim of this study was to assess the frequency and type of adverse reactions following influenza vaccination and its effects on lung function, dyspnoeic symptoms, exercise capacity, and clinical acute respiratory illness (ARI) in patients with COPD, and the relationship of these adverse effects to the degree of airflow obstruction.
A stratified, randomized, double-blind placebo-controlled study was conducted over an 18-month period at a single university hospital. In total, 125 patients with COPD were randomized to the vaccine group (62 patients who received purified trivalent split-virus vaccine injections) or the placebo group (63 patients). Local and systemic symptoms during the week following the injections were evaluated. Clinical ARI, lung function tests, dyspnoeic symptoms (assessed using a visual analogue scale), and a 6-min walking test were evaluated before and at 1 week and 4 weeks following vaccination.
The frequency of local adverse reactions was 27% in the vaccine group and 6% in the placebo group (P = 0.002). There was no significant difference in systemic adverse reactions between the vaccine and placebo groups (76% vs. 81%; P= 0.5). No difference was observed in the incidence of ARI between the vaccine and placebo groups during the first week (6.4% vs. 6.3%; P= 1) and the first 4 weeks (24.2% vs. 31.7%; P= 0.5) following vaccination. There was no significant change in lung function, dyspnoeic symptoms, and exercise capacity of the patients in both groups, at 1 week and 4 weeks following vaccination, regardless of the severity of COPD.
Influenza vaccination is associated with minimal local adverse reactions in patients with COPD. Vaccination does not cause systemic adverse reactions, induce clinical exacerbations or adversely affect lung function, dyspnoeic symptoms and exercise capacity in patients with COPD, regardless of the severity of airflow obstruction.
本研究旨在评估慢性阻塞性肺疾病(COPD)患者接种流感疫苗后不良反应的频率和类型,及其对肺功能、呼吸困难症状、运动能力和临床急性呼吸道疾病(ARI)的影响,以及这些不良反应与气流阻塞程度的关系。
在一所大学医院进行了一项为期18个月的分层、随机、双盲、安慰剂对照研究。总共125例COPD患者被随机分为疫苗组(62例接受纯化三价裂解病毒疫苗注射)或安慰剂组(63例)。评估注射后一周内的局部和全身症状。在接种疫苗前、接种后1周和4周评估临床ARI、肺功能测试、呼吸困难症状(使用视觉模拟量表评估)和6分钟步行试验。
疫苗组局部不良反应的发生率为27%,安慰剂组为6%(P = 0.002)。疫苗组和安慰剂组全身不良反应无显著差异(76%对81%;P = 0.5)。接种疫苗后的第一周(6.4%对6.3%;P = 1)和前4周(24.2%对31.7%;P = 0.5),疫苗组和安慰剂组的ARI发生率无差异。无论COPD的严重程度如何,两组患者在接种疫苗后1周和4周时的肺功能、呼吸困难症状和运动能力均无显著变化。
COPD患者接种流感疫苗后局部不良反应极小。无论气流阻塞的严重程度如何,接种疫苗不会引起全身不良反应、诱发临床病情加重或对COPD患者的肺功能、呼吸困难症状和运动能力产生不利影响。