Wat Dennis, Gelder Colin, Hibbitts Sam, Bowler Ian, Pierrepoint Marcus, Evans Rachel, Doull Iolo
Department of Cystic Fibrosis, University Hospital of Wales, Cardiff, UK.
J Cyst Fibros. 2008 Jan;7(1):85-8. doi: 10.1016/j.jcf.2007.05.002. Epub 2007 Jul 5.
Influenza vaccination is generally recommended to patients with Cystic Fibrosis (CF). Previous studies have shown that influenza infections cause worsening lung functions, disease progression and increase propensity of bacterial infections in CF. However, the clinical evidence in the effectiveness of influenza vaccination in CF is lacking.
This study retrospectively reviewed the influenza vaccination status in the patients with CF and compared the influenza infection rates between the vaccinated and non-vaccinated groups. Finally the factors associated with non-adherence with vaccination were determined.
Nasal swabs were obtained from 63 patients with CF between the age of 6 months to 18 years routinely and during respiratory exacerbations between October 2003 to April 2004. Influenza A and Influenza B were detected using Nucleic Acid Sequence Based Amplification (NASBA). The influenza vaccination status of these patients was retrospectively reviewed.
41 patients (65%) were vaccinated against influenza. For the 22 patients (35%) who were not vaccinated, 7 of them were scared of needles leading to non-adherence. Influenza virus was detected on 5 occasions; 3 were Influenza A (60%) and 2 were Influenza B (40%). 1 virus in the vaccinated group and 4 in the non-vaccinated were detected during the study period (p-value=0.046).
Although the current available evidence to support routine influenza vaccination is limited in CF, this study has shown that such practice may yet play a role in preventing its subsequent acquisition.
一般建议囊性纤维化(CF)患者接种流感疫苗。既往研究表明,流感感染会导致CF患者肺功能恶化、疾病进展,并增加细菌感染的倾向。然而,缺乏关于CF患者接种流感疫苗有效性的临床证据。
本研究回顾性分析CF患者的流感疫苗接种情况,比较接种组和未接种组的流感感染率。最后确定与未坚持接种疫苗相关的因素。
2003年10月至2004年4月期间,对63例年龄在6个月至18岁之间的CF患者在常规检查时以及呼吸道病情加重时采集鼻拭子。采用基于核酸序列扩增(NASBA)的方法检测甲型流感和乙型流感。对这些患者的流感疫苗接种情况进行回顾性分析。
41例患者(65%)接种了流感疫苗。在未接种疫苗的22例患者(35%)中,有7例因害怕打针而未坚持接种。共检测到5次流感病毒;3次为甲型流感(60%),2次为乙型流感(40%)。研究期间,接种组检测到1例病毒,未接种组检测到4例(p值=0.046)。
尽管目前支持CF患者常规接种流感疫苗的现有证据有限,但本研究表明这种做法可能在预防后续感染方面发挥作用。