Cimen Pinar, Unlu Mehmet, Kirakli Cenk, Katgi Nuran, Ucsular Fatma Demirci, Ayranci Aysu, Guclu Salih Zeki
Pulmonary Division, Izmir Training and Research Hospital for Thoracic Medicine and Surgery, Yenişehir, Izmir, Turkey.
Respir Care. 2015 Feb;60(2):239-43. doi: 10.4187/respcare.03350. Epub 2014 Oct 14.
Exacerbations of COPD are a major component of the socioeconomic burden related to COPD, and frequent exacerbations are associated with greater decline in health status. Tracheobronchial infections are involved in 50-70% of exacerbations, so influenza and pneumococcal vaccines are recommended for prevention. The aim of this study was to determine the level of knowledge among COPD patients about the vaccines, find the rate of patients inoculated with both influenza and pneumococcal vaccines, and assess the effectiveness of vaccination status.
Patients with COPD were recruited from the out-patient clinic of our hospital between September and October 2012. Subject demographic data such as age, gender, level of education, and smoking status were recorded. Vaccination status, number of subjects who were informed by a health-care professional about immunization, and COPD-related emergency or hospital admissions triggered by tracheobronchial infections over 1 y after administration of both influenza and pneumococcal vaccines were noted.
Eighty-eight subjects were enrolled during the study period. Eighty-two subjects were male (93.2%), 6 subjects were female (6.8%), and the median age was 61.5 y. According to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2006 classification, 5 subjects were in stage 1 (5.7%), 22 subjects were in stage 2 (25%), 34 subjects were in stage 3 (38.6%), and 27 subjects were in stage 4 (30.7%). Sixty-two subjects had graduated from primary school (70.5%), 21 subjects had graduated from high school (23.9%), one subject had graduated from university (1.1%), and 4 subjects had no education (4.5%). Forty-five subjects (51%) were vaccinated. There was no significant correlation between level of education and vaccination status (P=.37). Both COPD-related emergency department and hospital visits were significantly decreased in vaccinated patients with COPD (P<.001 and P=.02, respectively). Of all the subjects, 39.7% (35 of 88 subjects) mentioned that no health-care professional recommended vaccination.
Physicians should be more aware of vaccination and recommend both influenza and pneumococcal vaccines to all patients with COPD to reduce exacerbations.
慢性阻塞性肺疾病（COPD）急性加重是COPD相关社会经济负担的主要组成部分，频繁急性加重与健康状况的更大下降相关。50% - 70%的急性加重与气管支气管感染有关，因此推荐接种流感疫苗和肺炎球菌疫苗进行预防。本研究的目的是确定COPD患者对疫苗的了解程度，找出同时接种流感疫苗和肺炎球菌疫苗的患者比例，并评估疫苗接种状态的有效性。
2012年9月至10月期间，从我院门诊招募COPD患者。记录受试者的人口统计学数据，如年龄、性别、教育程度和吸烟状况。记录疫苗接种状态、由医护人员告知免疫接种的受试者人数，以及接种流感疫苗和肺炎球菌疫苗后1年内因气管支气管感染引发的COPD相关急诊或住院情况。
研究期间共纳入88名受试者。82名受试者为男性（93.2%），6名受试者为女性（6.8%），中位年龄为61.5岁。根据慢性阻塞性肺疾病全球倡议（GOLD）2006年分类，1期5名受试者（5.7%），2期22名受试者（25%），3期34名受试者（38.6%），4期27名受试者（30.7%）。62名受试者小学毕业（70.5%），21名受试者高中毕业（23.9%），1名受试者大学毕业（1.1%），4名受试者未接受教育（4.5%）。45名受试者（51%）接种了疫苗。教育程度与疫苗接种状态之间无显著相关性（P = 0.37）。接种疫苗的COPD患者的COPD相关急诊和住院次数均显著减少（分别为P < 0.001和P = 0.02）。在所有受试者中，39.7%（88名受试者中的35名）表示没有医护人员推荐接种疫苗。
医生应更加重视疫苗接种，向所有COPD患者推荐流感疫苗和肺炎球菌疫苗，以减少急性加重。
